Harmonizing religion and health: an exploration of religious reasons for defaulting ARVs among people living with HIV and AIDS in Gweru, Zimbabwe

Mutambara, Julia; Sodi, Tholene; Mtemeri, Joefrey; Makomo, Marcia

doi:10.1080/09540121.2020.1724255

Cited by 15 publications

(31 citation statements)

References 21 publications

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“…Second, while differences between the pre-treat all, and treat-all time periods have been observed in these data, it cannot be inferred that these are directly due to the change in national policies as opposed to other confounding or unobserved factors. These include religious beliefs, particularly amongst those belonging to organizations that promote faith-healing and alternative medicines [44,45], economic changes, differentiated care, and co-morbidities, PLOS GLOBAL PUBLIC HEALTH among others. Third, data were collected in the early implementation phase of the treat-all approach when there were some clients previously enrolled into care and already eligible for ART under the new guidelines.…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Incidence and predictors of attrition among patients receiving ART in eastern Zimbabwe before, and after the introduction of universal ‘treat-all’ policies: A competing risk analysis

Tlhajoane

Dzamatira

Kadzura

et al. 2021

PLOS Glob Public Health

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As HIV treatment is expanded, attention is focused on minimizing attrition from care. We evaluated the impact of treat-all policies on the incidence and determinants of attrition amongst clients receiving ART in eastern Zimbabwe. Data were retrospectively collected from the medical records of adult patients (aged≥18 years) enrolled into care from July 2015 to June 2016—pre-treat-all era, and July 2016 to June 2017—treat-all era, selected from 12 purposively sampled health facilities. Attrition was defined as an absence from care >90 days following ART initiation. Survival-time methods were used to derive incidence rates (IRs), and competing risk regression used in bivariate and multivariable modelling. In total, 829 patients had newly initiated ART and were included in the analysis (pre-treat-all 30.6%; treat-all 69.4%). Incidence of attrition (per 1000 person-days) increased between the two time periods (pre-treat-all IR = 1.18 (95%CI: 0.90–1.56) versus treat-all period IR = 1.62 (95%CI: 1.37–1.91)). In crude analysis, patients at increased risk of attrition were those enrolled into care during the treat-all period, <34 years of age, WHO stage I at enrolment, and had initiated ART on the same day as HIV diagnosis. After accounting for mediating clinical characteristics, the difference in attrition between the pre-treat-all, and treat-all periods ceased to be statistically significant. In a full multivariable model, attrition was significantly higher amongst same-day ART initiates (aSHR = 1.47, 95%CI:1.05–2.06). Implementation of treat-all policies was associated with an increased incidence of ART attrition, driven largely by ART initiation on the same day as HIV diagnosis which increased significantly in the treat all period. Differentiated adherence counselling for patients at increased risk of attrition, and improved access to clinical monitoring may improve retention in care.

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Section: Plos Global Public Healthmentioning

confidence: 99%

Incidence and predictors of attrition among patients receiving ART in eastern Zimbabwe before, and after the introduction of universal ‘treat-all’ policies: A competing risk analysis

Tlhajoane

Dzamatira

Kadzura

et al. 2021

PLOS Glob Public Health

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“…[IDI 15, 43 years, Christian, small scale trader] Prayer was used either exclusively or in combination with other paradigms. This has been noted in other African countries-for example when dealing with the uncertainty brought by infectious illnesses like HIV/AIDS [25,29]. In this study, prayer was either used in combination with public health prevention measures-mostly hand washing, or with traditional herbs.…”

Section: Divine Intervention: Prayer For Protectionmentioning

confidence: 95%

Contested or complementary healing paradigms? Women’s narratives of COVID-19 remedies in Mwanza, Tanzania

Mshana

Mchome

Aloyce

et al. 2021

J Ethnobiology Ethnomedicine

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Background COVID-19 has caused worldwide fear and uncertainty. Historically, the biomedical disease paradigm established its dominance in tackling emerging infectious illnesses mainly due to innovation in medication and advances in technology. Traditional and religious remedies have emerged as plausible options for prevention and treatment of COVID-19, especially in Africa and Asia. The appeal of religious and traditional therapies against COVID-19 in the African setting must be understood within the historical, social, and political context. This study explored how women and community members dealt with suspected symptoms of COVID-19 in Mwanza, Tanzania. Methods This study was conducted in Nyamagana and Ilemela districts of Mwanza, Tanzania, between July and August 2020. We conducted 18 mobile phone in-depth interviews with a purposively selected sample of women aged 27–57 years participating in an existing longitudinal study. For safety reasons, smart mobile phones were used to collect the data. Each interview was audio recorded after obtaining verbal consent from the participants. The audio files were transferred to computers for analysis. Four researchers conducted a multistage, inductive analysis of the data. Results Participants reported wide use and perceived high efficacy of traditional remedies and prayer to prevent and treat suspected symptoms of COVID-19. Use was either alone or combined with public health recommendations such as hand washing and crowd avoidance. Despite acknowledging that a pathogen causes COVID-19, participants attested to the relevance and power of traditional herbal medication and prayer to curb COVID-19. Four main factors underline the symbolic efficacy of the traditional and religious treatment paradigms: personal, communal, and official reinforcement of their efficacy; connection to local knowledge and belief systems; the failure of biomedicine to offer a quick and effective solution; and availability. Conclusions In the context of emerging contagious illnesses, communities turn to resilient and trusted treatment paradigms to quell fear and embrace hope. To tackle emerging infections effectively, it is essential to engage the broader sociopolitical landscape, including communal considerations of therapeutic efficacy.

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“…Local researchers [12] published a paper last year stating that people living with HIV (PLWHIV) in Gweru Zimbabwe defaulted medications because they believed in faith healing, alternative medicines, perceived spirituality as the main cause of HIV and AIDS. Furthermore, they had an allegiance to church values.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, they had an allegiance to church values. They showed the need to provide HIV and AIDS education to leaders of religious organizations so as to harmonize religion and HIV and AIDS treatment [12]. The importance of finding ways to engage R/S stakeholders in HIV care is also highlighted by Becker & Geissler who argue that religious groupings are instrumental in, instrumentalised by, and instrumentalising the organisation of HIV-related interventions [13].…”

Section: Introductionmentioning

confidence: 99%

The Importance of Considering Religious and Spiritual Ontologies in the Care of HIV Patients in Zimbabwe - A Scoping Literature Review

Grossenbacher¹,

Mutambara²,

Midzi³

et al. 2021

IJHPEBS

Self Cite

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Background: HIV continues to have a major impact on morbidity and mortality in Zimbabwe.Religion/Spirituality (R/S) including traditional beliefs and practices (TP) play an important role for most people living with HIV (PLWHIV) in Zimbabwe. PLWHIV conceive and practice healing holistically, embracing not only the physical conditions, but also the spiritual, psycho-emotional, social, and ecological dimensions. Objective: This scoping review aims to systematically map the research done around R/S and TP and HIV in Zimbabwe. It intends to describe what is known about the role and influence of R/S on the experience of living with HIV in Zimbabwe in general and especially, to illustrate the influence of R/S and TP on the physical and psychological wellbeing of PLWHIV, and the access to HIV care. Design: This scoping review followed the Joanna Briggs Institute's guidelines. The online databases Medline & ATLA were used to identify articles published between 2010-2021 about R/S and TP and HIV in Zimbabwe. The review includes textual papers, qualitative, quantitative, and mixed studies. Results: 638 records were found and screened for inclusion. 46 records were considered relevant for the qualitative and quantitative synthesis. Most articles (27) addressed the influence of traditional beliefs and practices on health and HIV and 16 records examined the influence of religious beliefs and religious groups' attitude on HIV. The qualitative synthesis illustrates the influence of R/S and TP on physical and psychological wellbeing and on access to HIV care of PLWHIV in Zimbabwe, thus portraying the medical relevance of R/S issues and TP. Further synthesis identified three areas of conflict with biomedical practice: The bio-psycho-socio-spiritual understanding of health and illness, the notion of patriarchy, and the perception of sexuality and procreation. Here religious/spiritual ontologies may lead to compromised biomedical therapy outcomes. Conclusion: This scoping review includes papers of authors from different backgrounds (theology, medicine, sociology). The synthesis of the content of the records revealed a coherent picture of themes addressed and problems identified. Thus, this review is a fair description of the experience of living with HIV in Zimbabwe and the medical relevance of R/S and TP. The findings show that religious/spiritual ontologies need to be considered and integrated into the design of new health programs. It must be the aim to avoid compromised therapy outcome and to further a holistic support of PLWHIV. This is only possible in collaboration with religious stakeholders and traditional practitioners.

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Harmonizing religion and health: an exploration of religious reasons for defaulting ARVs among people living with HIV and AIDS in Gweru, Zimbabwe

Cited by 15 publications

References 21 publications

Incidence and predictors of attrition among patients receiving ART in eastern Zimbabwe before, and after the introduction of universal ‘treat-all’ policies: A competing risk analysis

Incidence and predictors of attrition among patients receiving ART in eastern Zimbabwe before, and after the introduction of universal ‘treat-all’ policies: A competing risk analysis

Contested or complementary healing paradigms? Women’s narratives of COVID-19 remedies in Mwanza, Tanzania

The Importance of Considering Religious and Spiritual Ontologies in the Care of HIV Patients in Zimbabwe - A Scoping Literature Review

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