title: Factors associated with poor adherence to anti-retroviral therapy in patients attending a rural health centre in South Africa.
abstract: 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.
authors.affiliation: Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Mthatha, ECP, South Africa. vivekbhat2005@yahoo.com
authors.forename: V G
authors.initials: VG
authors.lastname: Bhat
authors.forename: M
authors.initials: M
authors.lastname: Ramburuth
authors.forename: M
authors.initials: M
authors.lastname: Singh
authors.forename: O
authors.initials: O
authors.lastname: Titi
authors.forename: A P
authors.initials: AP
authors.lastname: Antony
authors.forename: L
authors.initials: L
authors.lastname: Chiya
authors.forename: E M
authors.initials: EM
authors.lastname: Irusen
authors.forename: P P
authors.initials: PP
authors.lastname: Mtyapi
authors.forename: M E
authors.initials: ME
authors.lastname: Mofoka
authors.forename: A
authors.initials: A
authors.lastname: Zibeke
authors.forename: L A
authors.initials: LA
authors.lastname: Chere-Sao
authors.forename: N
authors.initials: N
authors.lastname: Gwadiso
authors.forename: N C
authors.initials: NC
authors.lastname: Sethathi
authors.forename: S R
authors.initials: SR
authors.lastname: Mbondwana
authors.forename: M
authors.initials: M
authors.lastname: Msengana
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents
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