Non-adherence to ART medication regimens among people living with HIV, who are registered with Leratong hospital in Gauteng province, South Africa

Moiloa, Edwin Mohlalefi
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Stellenbosch : Stellenbosch University
ENGLISH ABSTRACT: The study sought to establish the causes of non-adherence to ART medication regimens among people living with HIV. The research was conducted at Leratong Hospital in Johannesburg, Gauteng province, South Africa. The researcher selected a qualitative design in which 24 patients on ART and six healthcare providers in the field of HIV/AIDS, who fulfilled inclusion criteria of 18 and above years, were interviewed. Tape-recorded interviews as an instrument of data collection was used and patient-participants were approached and requested to participate in one to one interview as they came to collect their medication. Health personnel were approached in their respective offices and asked to be interviewed. Thematic Content Analysis (TCA) was later used to generate themes. The results indicated that adherence levels among the patients were sub optimal (less than 95%). Social economic related factors such as poverty, stigma and fear of disclosure; and medication side effects profoundly influenced adherence. Patient-related factors such as lack of social support, preference of traditional medicines, feeling better, substance abuse; and one health system-related factor being staff shortages, had a little contribution to poor medication adherence. According to the study findings, the process of ART delivery at the clinic had no contribution to patients‟ non-compliance. In fact it was found to have been intended at providing extrinsic motivation to, and raising the levels of adherence among the patients. When the patients stated their views concerning the programme, the major problem lay with strict time rules and that gave birth to forgetfulness. Their suggestion directed not to the health centers, but sorely to the government and all stakeholders including the ARV drugs-manufacturers, was that ART be provided in the form of three to six months injection. The findings revealed that stigma exacerbates non-adherence, so, there is a need to intensify health education campaigns against stigma in communities, workplaces and households. The findings from this study showed a significant relationship between treatment adherence and gender, in which women are generally more compliant than men to ART, so it was recommended that men be given extra pre-ARV counseling and compliance checking.
AFRIKAANSE OPSOMMING: Die primêre doel van hierdie studie was om die redes te bepaal waarom MIV-pasiënte nie hulle antiretrovirale medikasie volgens die voorgeskrewe protokol en voorskrif gebruik nie. Die studie is gedoen by die Leratong Hospitaal in Johannesburg, Gauteng, Suid-Afrika Die navorser het 'n kwalitatiewe ontwerp gebruik en het onderhoude gevoer met 24 pasiënte (wat antiretroviale medikasie gebruik) en ses gesondheidsorgwerkers. Beide die pasiënte en die gesondheidsorgwerkers het aan die voorafbepaalde kriteria vir die studie voldoen. Resultate toon dat pasiënte nie altyd by die voorskrifte vir die gebruik van hulle medikasie hou nie en dat dat daar 'n sub-optimale (minder as 95%) voldoening aan medisyne-voorskrifte was. Redes vir hierdie swak voldoening aan voorskrifte kan grootliks toegeskryf word aan armoede, stigma en newe-effekte van die medikasie. Pasiënt-verwante redes, soos die gebrek aan sosiale ondersteuning en voorkeur vir tradisionele medisyne, het 'n geringer bydrae gelewer tot hierdie swak voldoening aan medisyne-voorskrifte. Volgens die studie het het die proses, waarvolgens antiretoviale medikasie deur die klinieke voorsien word, nie 'n beduidende rol gespeel in die geneigdheid van pasiënte om nie aan medisyne-voorskrifte te voldoen nie. Dit het egter geblyk dat die streng tydreëls wat deur die medisyne-protokolle voorgeskryf word, daartoe gelei het dat pasiënte dikwels vergeet het om hulle medikasie te neem. Pasiënte het sterk vertoë tot farmaseutiese ondernemings gerig om te probeer om medikasie te onwikkel wat op 'n drie- tot ses maandelikse basis per inspuiting toegedien kan word. Die studie het ook aangetoon dat stigma die geneigdheid om nie te voldoen aan medisyne-vereistes nie vererger en dat opvoedkundige programme om stigma te verminder, versnel sal moet word binne ondernemings. 'n Laaste bevinding was dat daar 'n positiewe verwantskap is tussen geslag en die geneigdheid om by medisyne-voorskrifte te hou. Vroulike pasiënte is baie meer getrou in die neem van hulle antiretovirale medikasie.
HIV infections -- Treatment -- South Africa -- Gauteng, Patient compliance -- South Africa -- Gauteng