Alcohol use among people living with HIV/AIDS (PLWHA) on Highly Active Antiretroviral Therapy (HAART) at Otjiwarongo ART Clinic and its effects on their adherence to HAART

Chikwati, Enerst Mukono (2014-04)

Thesis (MPhil)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Alcohol use among PLWHA has long been recognized as a challenge in terms of HIV disease progression. However no local (Namibian) study has been done to look at prevalence of alcohol use among PLWHA on HAART and its effect on the patients’ adherence to HAART. A cross sectional survey was conducted at Otjiwarongo ART clinic to look at the proportion of PLWHA who use alcohol and the association between alcohol use and adherence to HAART. The target population was PLWHA on HAART at Otjiwarongo ART Clinic who; are 18 years and older and have been on HAART for a minimum of three months. Systematic sampling was used to select participants. A total sample size of 102 participants was obtained. Of those participants, 61(59.8%) were females and 41(40.2%) were males. Of the 102 participants, 14(13.73%) were in the age range of 18-28, 36(35.3%) in the age range of 30-39, 32(31.4%) in the age range of 40-49 and 20(19.6%) were in the age range of above or equal to 50 years. Of the total participants, 54(52.9%) used alcohol and 48(47%) were non-alcohol users. Of those who used alcohol 33(32.4%) were hazardous alcohol users (Abuse) while 21(20.6%) were non-hazardous alcohol users (Alcohol use). Of the 102 participants, 90(88.2%) were adherent to HAART in the four days prior to contact of the survey. These participants managed to take 95% or more of the total doses of their antiretroviral medicines. A total of 12(11.8%) of the participants were non adherent to HAART in the four days preceding the survey. Of the 33 participants who are hazardous alcohol users, 26(78.8%) were adherent to HAART compared to 7(21.2%) who were non adherent to HAART. The picture changes among those who did not use alcohol. Of the 48 participants who did not use alcohol, 44(91.7%) were adherent to HAART and 4(8.3%) were not adherent. What is interesting to note is the fact that of those who were non-hazardous alcohol users, adherence to HAART remained high. Adherence for this group was 95.2 %( 20 out of 21 participants). This study found that PLWHA on HAART Otjiwarongo hospital use alcohol more than the general population. This goes to show that alcohol abuse among PLWHA is indeed a problem which needs urgent attention Though the adherence is good among all the other PLWHA on HAART, adherence was particularly low in those PLWHA who were hazardous alcohol users (Alcohol Abusers). Adherence in this group was significantly low. This goes to show than hazardous alcohol use is associated with poor adherence to HAART. This re-emphasizes the need to screen all PLWHA for alcohol abuse before HAART is started so that appropriate support and advice can be provided.

AFRIKAANSE OPSOMMING: Alkoholgebruik onder mense wat met MIV/Vigs leef (PLWHA) word lank reeds erken as ’n uitdaging ten opsigte van MIV-siekteprogressie. Geen plaaslike (Namibiese) studie is egter nog onderneem om te ky kna die voorkomssyfer van alkoholgebruik onder PLWHA op hoogs aktiewe antiretroviraleterapie (HAART) en die effek daarvan op die pasiënte se navolging van HAART nie. ’n Deursnee-opname is by die Otjiwarongo ART-kliniek onderneem om te bepaal watter deel van PLWHA alkoholgebruik en wat die verband tussen alkoholgebruik en die navolging van HAART is. Die teikenbevolking was PLWHA op HAART by Otjiwarongo ART-kliniek wat 18 jaar of ouer is en reeds minstens drie maande lank HAART gebruik. Sistematiese toetsing is gebruik om deelnemers te kies. ’n Totale steekproef van 102 deelnemers is verkry. Van hierdie deelnemers was 61 (59.8%) vroue en 41 (40.2%) mans. 14 (13.73%) van die 102 deelnemers was in die ouderdomsgroep 18-28, 36 (35.3%) in die ouderdomsgroep 30-39, 32 (31.4%) in die ouderdomsgroep 40-49 en 20 (19.6%) was in die ouderdomsgroep 50 jaar of ouer. Van die totale groep het 54 (52.9%) alkoholgebruik en 48 (47%) was nie-gebruikers van alkohol. Van diegene wat alcohol gebruik het, was 33 (32.4%) oormatige alkoholgebruikers (misbruikers) terwyl 21 (20.6%) matige alkoholgebruikers was. 90 (88.2%) van die 102 deelnemers het in die vierdae voor kontak met die opname die HAART gevolg. Hierdie deelnemers het 95% of meer van die totale dosisse van hul antiretrovirale medisyne ingeneem. Altesaam 12 (11.8%) van die deelnemers het nie in die vier dae voor kontak met die opname die HAART gevolg nie. Van die 33 deelnemers wat oormatige alkoholgebruikers was, het 26 (78.8%) die HAART gevolg in vergelyking met 7 (21.1%) wat nie die HAART gevolg het nie. Die prentjie verander onder diegene wat nie alcohol gebruik het nie. Van die 48 deelnemers wat nie alcohol gebruik het nie, het 44 (91.7%) die HAART gevolg en 4 (8.3%) het dit nie gevolg nie. Dit is interessant om daarop te let dat van diegene wat matige alkoholgebruikers was die navolging van HAART hoog gebly het. Navolging vir hierdie groep was 95.2% (20 uit die 21 deelnemers). Hierdie studie het bevind dat PLWHA op HAART in die Otjiwarongo-hospitaal meer alcohol gebruik as die algemene bevolking. Dit dui daarop dat alkoholmisbruik onder PLWHA inderdaad ’n problem is wat dringende aandag vereis. Hoewel die navolging onder al die ander PLWHA op HAART goed was, was die navolging besonder laag by dié PLWHA wat oormatige alkoholgebruikers (alkoholmisbruikers) was. Navolging in hierdie groep was aansienlik laag. Did dui daarop dat oormatige alkoholgebruik met swak navolging van HAART geassosieer word. Dit herbeklemtoon die behoefte aan sifting van alle PLWHA vir alkoholgebruik voordat met HAART begin word sodat behoorlike steun en advise voorsien kan word.

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