SciELO - Scientific Electronic Library Online

 
vol.14 número1 índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Health SA Gesondheid (Online)

versão On-line ISSN 2071-9736
versão impressa ISSN 1025-9848

Health SA Gesondheid (Online) vol.14 no.1 Cape Town  2009

 

ORIGINAL RESEARCH

 

Speaking to experts and patients: Recommendations for improving antiretroviral therapy (ART) adherence

 

 

Janice Frank; Norman Duncan

Department of Psychology, University of the Witwatersrand, South Africa

Correspondence

 

 


ABSTRACT

This article reports on the findings of a study that aimed to explore experts' and patients' opinions and recommendations regarding adherence to antiretroviral medication. This study was prompted firstly by the lack of existing local research on adherence to antiretroviral therapy (ART) and secondly by the importance of adherence, given the recent introduction of ART to the public health sector. Four experts and seven patients were interviewed. The experts had worked within the HIV/AIDS field for at least two years while the patients (chosen from public antiretroviral roll-out programmes) had been on ART for at least six months. These interviews were transcribed and analysed using thematic content analysis. This article focuses specifically on the recommendations for improving adherence that emerged from the experts' and patients' interviews. While the experts and patients generated two fairly distinct sets of recommendations (clearly informed by their different experiences and knowledge), both groups emphasised the importance of the mediating effects of social support and the healthcare provider-patient relationship in adherence to ART medication.

Keywords: HIV/AIDS; antiretroviral medication; experts; patients; healthcare


OPSOMMING

Gesprekke met kundiges en pasiënte: Aanbevelings ter verbetering van ART-nakoming. Hierdie artikel doen verslag oor die bevindinge van 'n studie wat kundiges en pasiënte se menings en aanbevelings ten opsigte van die nakoming van antiretrovirale medikasievoorskrifte ondersoek het. Die studie is in die eerste plek uitgevoer na aanleiding van die gebrek aan bestaande plaaslike navorsing oor die nakoming van antiretrovirale terapie (ART) en in die tweede plek na aanleiding van die belangrikheid van nakoming in die lig van die onlangse bekendstelling van ART in die openbaregesondheidsektor. Onderhoude is met vier kundiges en sewe pasiënte gevoer. Die kundiges het vir ten minste twee jaar binne die MIV/Vigs-omgewing gewerk en die pasiënte (wat uit die openbare antiretrovirale bekendstellingsprogramme gekies is) het ten minste ses maande van ART-terapie ondergaan. Die onderhoude is getranskribeer en met die gebruik van tematiese inhoudsanalise ontleed. Hierdie artikel fokus spesifiek op die aanbevelings vir die verbetering van nakoming wat uit die onderhoude met die kundiges en die pasiënte gespruit het. Terwyl die kundiges en die pasiënte twee redelik uiteenlopende stelle aanbevelings gemaak het (wat duidelik deur hulle onderskeie ondervinding en kennis beïnvloed is), het altwee groepe beklemtoon dat die bemiddelende effek van maatskaplike ondersteuning en die verhouding tussen die pasiënt en die voorsiener van gesondheidsorg 'n belangrike rol speel in die nakoming van ART-medikasievoorskrifte.


 

 

“Full text available only in PDF format”

 

 

REFERENCES

Akula, S.L., 2002, 'Do heterosexuals with HIV/AIDS face discrimination and stigma after disclosure: A study conducted in a city (Visakhaptanam) in India', paper presented at International Conference AIDS, Andhra University, Visakhapatnam, India, 7-12 July.         [ Links ]

Berg, K.M., Demas, P.A., Howard, A.A., Schoenbaum, E.E., Gourevitch, M.N. & Arnsten, J.H., 2004, 'Gender differences in factors associated with adherence to antiretroviral therapy', Journal of General Internal Medicine 19(11), 1111-1117        [ Links ]

Brief, D.J., Bollinger, A.R., Vielhauer, M.J., Berger-Greenstein, J.A., Morgan, E.E., Brady, S.M., Buondonno, L.M. & Keane, T.M., 2004, 'Understanding the interface of HIV, trauma, post-traumatic stress disorder, and substance use and its implications for health outcomes', AIDS Care 16(1), 97-120.         [ Links ]

Buick, D., Fisher, M., Horne, R. & Leake, H., 2004, 'Doubts about necessity and concerns about adverse effects: Identifying the types of beliefs associated with non-adherence to HAART', International Journal of STD and AIDS 15(1), 38-44.         [ Links ]

Burke, L.E., Dunbar-Jacob, J.M., Schlenk, E.A. & Matthews, J.T., 1998, 'Predictors of patient adherence: Patient characteristics', in S.A. Shumaker, E.B. Schron, J.K. Ockene & W.L. McBee (eds.), 1984, The handbook of health behaviour change, 2nd edn., pp. 5-31, Springer Publishing, New York.         [ Links ]

Butler, A., 2005, 'The negative and positive impacts of HIV/ AIDS on democracy in South Africa', Journal of Contemporary African Studies 23(1), 1-24.         [ Links ]

Chung, W.Y.R., Lam, S.W.C., Lau, T.F.J., Li, C.K.P., Nahas-Lopez, V. & Molassiotis, A., 2002, 'Factors associated with adherence to antiretroviral medication in HIV-infected patients', International Journal of STD and AIDS 13, 301-10.         [ Links ]

Frank, J., 2006, 'Exploring expert and patient opinions and recommendations regarding antiretroviral treatment compliance', Unpublished MA (Counselling Psychology) research report, University of the Witwatersrand.         [ Links ]

French, T., Weiss, L., Waters, M., Tesoriero, J., Finkelstein, R. & Agins, B., 2005, 'Correlation of a brief perceived stress measure with nonadherence to antiretroviral therapy over time', Journal of Acquired Immune Deficiency Syndromes 38(5), 590-597.         [ Links ]

Gifford, A., Bormann, J., Shively, M., Wright, B., Richman, D. & Bozzette, S., 2000, 'Predictors of self reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens', Journal of Acquired Immune Deficiency Syndromes 23(5), 386-395.         [ Links ]

Godin, G., Cote, L., Naccache, H., Lambert, L.D. & Trottier, S., 2005, 'Research group on behaviours in the field of health', AIDS Care 17(4), 493-504.         [ Links ]

Halkitus, P.N., Kutnick, A.H. & Slater, S., 2005, 'The social realities of adherence to protease inhibitor regimens: Substance use, health care and psychological states', Journal of Health Psychology 10(4), 545-558.         [ Links ]

Haynes, R.B., 2001, 'Improving patient adherence: State of the art, with a special focus on medication taking for cardiovascular disorders', in L.E. Burke & I.S. Ockene (eds.), Compliance in healthcare and research, Futura Publishing, New York.         [ Links ]

Heckman, B.D., Catz, S.L., Heckman, T.G., Miller, J.G. & Kalichman, S.C., 2004, 'Adherence to antiretroviral therapy in rural persons living with HIV disease in the United States', AIDS Care 16(2), 219-230.         [ Links ]

Ickovics, J.R. & Meade, C.S., 2002, Adherence to HAART among patients with HIV: Breakthroughs and barriers', AIDS Care 14, 309-318.         [ Links ]

Kalichman, S.C. & Rompa, D., 2003, 'HIV treatment adherence and unprotected sex practices in people receiving antiretroviral therapy', Sexually Transmitted Infections 7(1), 59-61.         [ Links ]

Kimmerling, M., Wagner, G. & Ghosh-Dastidar, B., 2003, 'Factors associated with accurate self-reported adherence to HIV antiretrovirals', International Journal of STD and AIDS, 14(4), 281-284.         [ Links ]

Kumarasamy, N., Safren, S.A., Ramimani, S.R., Pickard, R., James, R., Krishnan, A.K.S., Soloman, S. & Mayer, K.H., 2005, 'Barriers and facilitators to antiretroviral medication adherence among patients with HIV in Chennai, India: A qualitative study', AIDS Patient Care and STDs 19(8), 526-537.         [ Links ]

Lucas, G.M., Wu, A.W. & Cheever, L.W., 2004, 'Adherence to antiretroviral therapy: An update of current concepts', Current HIV/AIDS Reports 1(4), 172-180.         [ Links ]

Malan, J., 2003, HIV in our lives. A book of information sheets for people living with HIV, support groups and clinics, AIDS Law Project & Treatment Action Campaign, Johannesburg.         [ Links ]

Mann, T. & Roberts K.J., 2000, 'Barriers to antiretroviral medication adherence in HIV-infected women', AIDS Care 12, 377-386.         [ Links ]

Mannheimer, S., Hirsch, Y. & El-Sadr, W., 1998, 'The impact of the ALR alarm device on antiretroviral adherence among HIV-infected outpatients in Harlem', International Conference AIDS 12, 585-586.x        [ Links ]

Max, B. & Sherer, R., 2000, 'Management of the adverse effects of antiretroviral therapy and medication adherence', Clinical Infectious Diseases 30(2), S96-S116.         [ Links ]

May, J., Govender, J., Budlender, D., Mokate, R., Rogerson, C. & Stavrou, A., 1998, Poverty and inequality in South Africa: A report prepared for the Office of the Executive Deputy President and the Inter-Ministerial Committee for Poverty and Equality, viewed 24 March 2005, from http://www.polity. org.za/html/govdocs/reports/poverty/html.         [ Links ]

Mbali, M., 2004, 'The Treatment Action Campaign and the History of Rights Based Patient-Driven HIV/Aids Activism in South Africa', Research Report no. 9, Centre for Civil Society, University of Kwazulu-Natal.         [ Links ]

Meredith, K., Jeff, D.B., Mundy, L.M. & Fraser, V.J., 2001, 'Sources influencing patients in their HIV medication decisions', Health Education and Behavior 28(1), 40-50.         [ Links ]

Moosa, M.Y.H., Jeenah, F.Y. & Vorster, M., 2005, 'HIV in South Africa - depression and CD4 count', South African Journal of Psychiatry 11, 12-15.         [ Links ]

Murphy, D.A., Marielich, W.D., Hoffman, D. & Steers, W.N., 2004, 'Predictors of antiretroviral adherence', AIDS Care 16(4), 471-484.         [ Links ]

Phillips, K.D., Moneyham, L., Murdaugh, C., Boyd, M.R., Tavakoli, A., Jackson, K. & Vyavaharkar, M., 2005, 'Sleep disturbance and depression as barriers to adherence', Clinical Nursing Research 14(3), 273-293.         [ Links ]

Popp, D. & Fisher, J.D., 2002, 'First, do no harm: A call for emphasizing adherence and HIV prevention interventions in active antiretroviral therapy programs in the developing world', AIDS: Official Journal of the International AIDS Society 16(4), 676-678.         [ Links ]

Rothlind, J.C., Greenfield, T.M., Bruce, A.V., Meyerhoff, D.J., Filenniken, D.L., Lindgren, J.A. & Weiner, M.W., 2005, 'Heavy alcohol consumption in individuals with HIV infection: Effects on neuropsychological performance', International Neuropsychological Society 11(1), 70-83.         [ Links ]

Samet, J.H., Horton, N.J., Meli, S., Dukes, K., Tripps, T., Sullivan, L. & Freedberg, K.A., 2005, 'A randomised controlled trial to enhance antiretroviral therapy adherence in patients with a history of alcohol problems', Antiviral Therapy 10(1), 83-93.         [ Links ]

Seedat, M., Duncan, N. & Lazarus, S. (eds)., 2001, Community psychology, theory, method and practice, Oxford University Press, Cape Town.         [ Links ]

Shernoff, M., 2001, 'HIV Medication Adherence', FAMA Five Borough AIDS Mental Heath Alliance, 3(2), viewed 16 April 2004, from http://www.gaypsychotherapy.com/murray.htm.         [ Links ]

Silverman, D., 1999, Interpreting qualitative data: Methods of analysing talk, text and interaction, Sage, London.         [ Links ]

South African Department of Health, 2004, National antiretroviral treatment guidelines, Jacana, Johannesburg.         [ Links ]

Stone, V.E. & Smith, K.Y., 2004, 'Improving adherence to HAART', Journal of the National Medical Association 96(2), 27s-29s.         [ Links ]

Tindall, C. 2006. Issues of evaluation, in P. Banister, E. Burman, I. Parker, M. Taylor & C. Tindall (eds.), Qualitative methods in psychology: A research guide, pp. 142-159, Open University Press, Berkshire.         [ Links ]

Titscher, S., Meyer, M., Wodak, R. & Vetter, E., 2000, Methods of text and discourse analysis, pp. 76-91, Sage, London.         [ Links ]

Tobias, B.Q., 2001, 'A descriptive study of the cultural mores and beliefs toward HIV/AIDS in Swaziland, Southern Africa', International Journal for the Advancement of Counselling 23, 99-113.         [ Links ]

Treatment Action Campaign (TAC), 2006, 'Adherence and HIV resistance', viewed 27 September 2006, from www.tac.org.za/Documents/Literacy/Adherence.pdf.         [ Links ]

Turner, B.J., Laine, C., Cosler, L. & Hauck, W.W., 2003, 'Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users', Journal of General Internal Medicine 18(4), 248-257        [ Links ]

Van Vlaenderen, H. & Neves, D., 2004, 'Participatory action research and local knowledge in community contexts', in D. Hook (ed.), Critical psychology, pp. 445-464, University of Cape Town Press, Cape Town.         [ Links ]

Ware, N.C., Wyatt, M.A. & Tugenberg, T., 2005, 'Adherence, stereotyping and unequal HIV treatment for active users of illegal drugs', Social Science & Medicine 61(3), 565-576.         [ Links ]

Yun, L.W.H., Maravi, M., Kobayashi, J.S., Barton, P.L. & Davidson, A.J., 2005, 'Antidepressant treatment improves adherence to antiretroviral therapy among depressed HIV-infected patients', Journal of Acquired Immune Deficiency Syndromes 38(4), 432-438.         [ Links ]

 

 

Correspondence:
Janice Frank
Department of Psychology
University of the Witwatersrand
Johannesburg, Private Bag X3
P. O. Wits, 2050
South Africa
E-mail: janice.frank@wits.acza

Received: 22 May 2008
Accepted: 03 Nov. 2008
Published: 08 May 2009

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons