Patterns and predictors of antiretroviral therapy use among alcohol drinkers at HIV clinics in Tshwane, South Africa

Kekwaletswe, Connie T.; Morojele, Neo K.

doi:10.1080/09540121.2014.906558

Cited by 28 publications

(26 citation statements)

References 11 publications

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“…Six investigations found that stigma was significantly associated with poor self-reported adherence at the multivariate level, after adjusting for factors such as demographics, perceived health, structural barriers, and alcohol and drug use [42,44,45,47,49,56]. Two prospective investigations lent support to this association as well.…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 73%

“…These instruments are characterized by a range of subconstructs, including internalized (e.g., negative self-perception), anticipated (e.g., renegotiating social relationships), and enacted (e.g., healthcare discrimination) stigmas. A combination of enacted and anticipated stigma items was used for two studies [44,45], but the exact stigma measure used was not mentioned.…”

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 99%

“…However, multivariate and mediational analyses differed, so both were retained for the review. An additional two studies [44,45] reported on the same dataset, but different adherence outcomes were used in analyses, so both were retained.…”

Section: Search Strategy and Study Selectionmentioning

confidence: 99%

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The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

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Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 73%

Section: Studies That Combined Multiple Dimensions Of Stigmamentioning

confidence: 99%

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The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

2015

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“…Indications of the benefit of greater self-efficacy among individuals with HIV have been found in studies showing positive associations between medication adherence self-efficacy and medication adherence (Parsons et al, 2008; Kekwaletswe and Morojele, 2014), and between smoking cessation self-efficacy and successful smoking cessation in HIV-infected populations (Shuter et al, 2014). Notably, another study demonstrated an association between lower self-efficacy to resist drinking and higher levels of drinking among HIV-infected youths (Naar-King et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial

et al. 2016

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Heavy drinking among HIV-infected individuals is associated with health complications. Health-behavior self-efficacy may be characteristically low among this population, or negatively affected by HIV-infected status. We assessed whether self-efficacy to resist drinking increased during brief educational and motivational drinking-reduction interventions within HIV primary care, and whether increases in self-efficacy predicted drinking among HIV-infected heavy-drinkers. Results indicate that increases in self-efficacy from baseline to end-of-intervention inversely predicted drinking at end-of-intervention, and at follow-up. Findings suggest that brief treatment interventions within HIV primary care may promote self-efficacy; and that increases in self-efficacy predict initiation and maintenance of drinking reductions among HIV patients.

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“…Furthermore, binge drinking rather than the cumulative exposure of hazardous drinkers was predictive of non-adherence to ART [7]. A recent study conducted in HIV clinics in Tshwane, Gauteng province in South Africa, found a significant association between level of alcohol use and degree of non-adherence [27]. …”

Section: Introductionmentioning

confidence: 99%

Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa

et al. 2016

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BackgroundAt the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined.This study aimed to ascertain the knowledge, attitudes and practices of primary healthcare workers concerning the concurrent consumption of alcohol of clinic attendees who are prescribed antiretroviral drugs. An assessment of the exchange of information on the subject between clinic attendees and primary healthcare providers forms an important aspect of the research. A further objective of this study is an assessment of the level of alcohol consumption of people living with HIV and AIDS attending public health facilities in the Western Cape Province in South Africa, to which end, the study reviewed health workers’ perceptions of the problem’s extent. A final objective is to contribute to the development of evidence-based guidelines for AIDS patients who consume alcohol when on ARVs. The overall study purpose is to optimise antiretroviral health outcomes for all people living with HIV and AIDS, but with specific reference to the clinic attendees studied in this research.MethodsOverall the research study utilised mixed methods. Three group-specific questionnaires were administered between September 2013 and May 2014. The resulting qualitative data presented here supplements the results of the quantitative data questionnaires for HIV and AIDS clinic attendees, which have been analysed and written up separately. This arm of the research study comprised two, separate, semi-structured sets of interviews: one face-to-face with healthcare workers at the same primary healthcare clinics from which the clinic attendees were sampled, and the other with administrators from the local government health service via email. The qualitative analysis from the primary healthcare worker interviews has been analysed using thematic content analysis.ResultsThe key capacity gaps for nurses include the definition of different patterns and volumes of alcohol consumption, resultant health outcomes and how to answer patient questions on alcohol consumption while on antiretroviral treatment. Not only did the counsellors lack knowledge regarding alcohol abuse and its treatment, but they were also they were unclear on their role and rights in relation to their patients. Doctors highlighted the need for additional training for clinicians in diagnosing alcohol use disorders and information on the pharmacological interventions to treat alcoholism.ConclusionPertinent knowledge regarding patient alcohol consumption while taking ARVs needs to be disseminated to ...

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Patterns and predictors of antiretroviral therapy use among alcohol drinkers at HIV clinics in Tshwane, South Africa

Cited by 28 publications

References 11 publications

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature

Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial

Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa

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