Factors associated with poor adherence to anti-retroviral therapy in patients attending a rural health centre in South Africa.
South Africa has a very high HIV disease burden and proper patient adherence to anti-retroviral therapy (ART) is crucial in achieving optimal treatment outcomes. Factors influencing adherence include demographic and psychosocial factors, medication-related issues and other patient-related matters. This study was carried out in order to determine factors associated with poor compliance to anti-retroviral (ARV) medications in a rural setting. This interview-based descriptive and analytical study was carried out in a health centre where 168 patients who received ARVs were interviewed with pre-structured questionnaires, which covered various important compliance-related aspects. The results showed that 37.5% of the patients were non-adherent. Amongst men, poor adherence was seen in those who were single (48.9%), with tertiary education (60%), in those who consumed alcohol regularly (47.1%) and in those who were unemployed (56.1%). Higher rates of non-adherence in women was associated with being single (36.5%) and in those who used alcohol (60.7%). Medication-related adverse effects were reported in 47% of patients, notably, neuropathy, headache, nausea, loss of memory, diarrhoea and fatigue. Common reasons for missing doses were: being away from home (57.1%), simply forgot (41.3%), side effects (50.8%) and being too busy (49.2%). Poor adherence to ART is an important concern relating to HIV management in our setting and needs to be addressed with more patient-oriented interventions.
Bhat
V G
VG
Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, ECP, South Africa. vivekbhat2005@yahoo.com
Ramburuth
M
M
Singh
M
M
Titi
O
O
Antony
A P
AP
Chiya
L
L
Irusen
E M
EM
Mtyapi
P P
PP
Mofoka
M E
ME
Zibeke
A
A
Chere-Sao
L A
LA
Gwadiso
N
N
Sethathi
N C
NC
Mbondwana
S R
SR
Msengana
M
M
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012423:Rural Health; D012847:Single Person / Q000523:psychology; D012959:Socioeconomic Factors; D013019:South Africa; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring
D019380:Anti-HIV Agents
Clin Infect Dis. 1999 Oct;29(4):824-30
10589897
J Assoc Nurses AIDS Care. 2008 Mar-Apr;19(2):127-36
18328963
Soc Sci Med. 2008 Jul;67(2):301-10
18455285
J Adolesc Health. 2010 Mar;46(3):278-83
20159506
Antivir Ther. 2007;12(7):1067-74
18018765
Trop Med Int Health. 2007 May;12(5):687-94
17445136
J Infect Dis. 2007 Dec 1;196 Suppl 3:S469-73
18181696
AIDS Care. 2007 Nov;19(10):1210-8
18071964
HIV Med. 2003 Apr;4(2):133-8
12702134
J Clin Pharm Ther. 2006 Dec;31(6):605-16
17176366
Soc Sci Med. 2009 Oct;69(8):1177-85
19692165
AIDS Patient Care STDS. 2004 May;18(5):297-304
15186713
Health Place. 2009 Dec;15(4):1123-9
19596603
AIDS Care. 2003 Apr;15(2):217-30
12856343
Afr J AIDS Res. 2006 May;5(1):17-26
25875143
AIDS Patient Care STDS. 2008 Jan;22(1):71-80
18095837
Appl Nurs Res. 2011 Feb;24(1):1-9
20974052
J Adolesc Health. 2009 Feb;44(2):124-132
19167660
Ann Intern Med. 2007 Apr 17;146(8):564-73
17438315
Clin Infect Dis. 2003 Oct 15;37(8):1112-8
14523777
AIDS Res Ther. 2009 Apr 28;6:7
19400929
J Pain Symptom Manage. 2005 Feb;29(2):193-205
15793937
Int J Nurs Pract. 2008 Feb;14(1):3-10
18190478
AIDS Patient Care STDS. 2008 May;22(5):403-11
18373416
Lancet. 2006 Aug 5;368(9534):505-10
16890837
Pathol Biol (Paris). 2006 Dec;54(10):545-50
17027195
J Acquir Immune Defic Syndr. 2006 Dec 1;43(4):411-7
17099312
AIDS Care. 2002 Oct;14(5):607-17
12419110
J Assoc Nurses AIDS Care. 2006 Mar-Apr;17(2):4-15
16800163
Int J Drug Policy. 2007 Aug;18(4):319-25
17689381