Measuring adherence levels to antiretroviral treatment (ART) and assessing certain factors affecting adherence in a state primary health care clinic, Mitchells Plain Community Health Centre, South Africa

Engel, Tania (2008-12)

Thesis (MMed)--Stellenbosch University, 2016


ENGLISH ABSTRACT: Objective. Measuring adherence levels and assessing the impact on adherence to ART (antiretroviral treatment) of the factors: disclosure to partner, partner support, other support and length of time between diagnosis and ART commencement, in a state-run ART clinic at Mitchells Plain Community Health centre. Design. A retrospective case control study was conducted and the information was obtained by means of a file audit. Methods. Every 5th file was selected for the study and 199 participants were chosen based on the inclusion and exclusion criteria. Adherence for each patient was measured using a formula documented in a published study. For the comparison group 82 cases (non-adherent patients) were matched for age and gender with 82 adherent controls. Results. The mean adherence for the initial group of 199 participants was 80.1%. Disclosure to a partner and partner support were not found to significantly affect adherence. The time between HIV diagnosis and ART commencement was also not found to make a statistically significant difference to adherence. There appeared to be an association, though not statistically significant, between other support (not from the partner) and >95% adherence (p= 0.0579). Conclusion. It can be concluded that adherence is probably influenced by a wide variety of factors. More qualitative studies or larger samples are recommended to better assess the impact of partner support and acceptance of HIV on adherence. Approaches to partner disclosure prior to commencing ART should be reviewed. The mean adherence level of 80.1% is an indication that more work is urgently needed to improve adherence levels in state-run clinics in South Africa.

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