Barriers to adherence to antiretroviral treatment in a regional hospital in Vredenburg, Western Cape, South Africa

Abstract

BackgroundSouth Africa currently runs the largest public antiretroviral treatment (ART) programme in the world, with over 80% of people living with HIV and/or AIDS on ART. However, in order to appreciate the benefits of using ART, patients are subject to uncompromising and long-term commitments of taking at least 95% of their treatment as prescribed. Evidence shows that this level of adherence is seldom achieved because of a multilevel and sometimes interwoven myriad of factors.ObjectiveWe described the challenges faced by patients on ART in Vredenburg with regard to ART adherence.MethodsA descriptive qualitative research design was used. Eighteen non-adhering patients on ART in the Vredenburg regional hospital were purposefully selected. Using a semi-structured interview guide, we conducted in-depth interviews with the study participants in their mother tongue (Afrikaans). The interviews were audio-taped, transcribed verbatim and translated into English. The data were analysed manually using the thematic content analysis method.ResultsStigma, disclosure, unemployment, lack of transport, insufficient feeding, disability grants and alternative forms of therapy were identified as major barriers to adherence, whereas inadequate follow-ups and lack of patient confidentiality came under major criticisms from the patients.ConclusionInterventions to address poverty, stigma, discrimination and disclosure should be integrated with group-based ART adherence models in Vredenburg while further quantitative investigations should be carried out to quantify the extent to which these factors impede adherence in the community.

STACKing the odds for adolescent survival: health service factors associated with full retention in care and adherence amongst adolescents living with HIV in South Africa

“…It is unclear whether hurried appointments were due to health provider attitudes, administrative burden or to high patient load. This supports qualitative data from the adult literature of the importance of the relationship and engagement with healthcare providers [35]. Within Sub-Saharan Africa, increasing use of community health workers and peer supporters within clinic settings (e.g.…”

Challenges Facing Children Born with HIV: A Case Study of One Rural Schoolin Oshikoto Region of Namibia

“…This finding is contrary to what was found by Weiser, Tuller, Frongillo, Senkungu, Mukiibi and Bangsberg in Uganda that food insecurity and hunger were common barriers to ARV adherence [19]. Similarly, some studies found malnutrition, poverty, food insecurity and consumption pattern, which is less than three meals per day, as significantly associated with non-adherence to ART [16,20] Participants further indicated that a lack of confidentiality among family members is not a concern as most family members did not know their HIV status. Apart from the primary caregivers, the participants' HIV status is a secret.…”

“…However, accessing health care centres seems to be a problem is some countries such as Tanzania where a study by Nsimba, Irunde and Comoro reported lack of transport especially in remote areas as an additional challenge to accessing hospitals [15]. Similarly, a study carried out in South Africa on barriers to adherence to ART by Azia, Mukumbang and Van Wyk reported transport expenditures and distance as main obstacles for HIV-positive patients to access health facilities [16]. Namibia has thus done well in increasing access to healthcare facilities through standing and mobile clinics.…”

An Exploratory Study of the Determinants of Adherence to Antiretroviral Therapy by Adolescents and Youths in the Eastern Cape, South Africa

“…Consistent with Stanhope and Lancaster (2005), socio-demographic factors generally did not entirely predict ART adherence behaviour. However, other studies have shown that younger age (Eyassu et al, 2016;Williams et al, 2006), being female, under 35 years, single, and having higher educational status (Uzochukwu, Onwujekwe, Onoka, Okoli, Uguru, & Chukwuogo, 2009;Semvua et al, 2017;Kagee et al, 2011;Azia et al, 2016), significantly affect poorer adherence to ART. Contrastingly, Weiser, Wolfe and Bangsberg (2003) found no association between gender and adherence to ART.…”