Common problems with antiretroviral therapy among three Swedish groups of HIV infected individuals.
OBJECTIVE
The main objective of this study was to identify and compare the common problems and difficulties associated with combination antiretroviral therapy (CART) as experienced by three major groups of HIV infected individuals (homo- or bisexuals, former injecting drug users and origins of Sub-Saharan Africa) in Sweden.


METHODS
Based on the results from in-depth interviews with 15 representatives from the three major groups, a questionnaire was designed for use in a problem detection study (PDS). The study was conducted with 195 HIV-positive patients residing in the major cities of Sweden.


RESULTS
The overall response rate was 79%. The problems identified in all three groups were negative attitudes from the public, worries about disease progression or therapy failure, medication or drug-related problems and problems in connection to pharmacy visits. A specific problem in the homo- or bisexual group was drug-related problems such as adverse effects, drug interactions and pill burden. For former injecting drug users, the specific problem was disease-related conflicts with relatives and the problem of coping with the social and psychological burden caused by the HIV infection. The African group termed the risk of exposing their medication at the pharmacy as a specific problem, as this could reveal their HIV status.


CONCLUSIONS
Our findings regarding problems with CART in three patient groups in Sweden may be of use to tailor pharmacy care to HIV infected individuals. General strategies to improve adherence need to be complemented with approaches that will address the specific needs for the different patient groups affected by HIV. Further studies on group-specific interventions that promote concordance and adherence to CART will be necessary to minimize therapy failure and viral resistance.
Jallow
Amadou
A
Apoteket Källan, Box 64, 14501 Norsborg, Sweden. amadou.jallow@apoteket.se
Sporrong
Sofia Kälvemark
SK
Walther-Jallow
Lilian
L
Persson
Peter M
PM
Hellgren
Urban
U
Ericsson
Orjan
O
D017954:Africa South of the Sahara / Q000208:ethnology; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001727:Bisexuality; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology; D006716:Homosexuality; D006801:Humans; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
D019380:Anti-HIV Agents