Namibian prisoners describe barriers to HIV antiretroviral therapy adherence.
Little is available in scholarly literature about how HIV-positive prisoners, especially in low-income countries, access antiretroviral therapy (ART) medication. We interviewed 18 prisoners at a large prison in Namibia to identify barriers to medication adherence. The lead nurse researcher was a long-standing clinic employee at the prison, which afforded her access to the population. We identified six significant barriers to adherence, including (1) the desire for privacy and anonymity in a setting where HIV is strongly stigmatized; (2) the lack of simple supports for adherence, such as availability of clocks; (3) insufficient access to food to support the toll on the body of ingesting taxing ART medications; (4) commodification of ART medication; (5) the brutality and despair in the prison setting, generally leading to discouragement and a lack of motivation to strive for optimum health; and (6) the lack of understanding about HIV, how it is transmitted, and how it is best managed. Because most prisoners eventually transition back to communitysettings when their sentences are served, investments in prison health represent important investments in public health.
a Senior Superintendent and Head Nurse with Ministry of Safety and Security, Department of Correctional Service , Windhoek Correctional Facility , Windhoek , Namibia.
Nauyele
N
Shalihu
Louise
L
Pretorius
Agnes
A
van Dyk
Ann
A
Vander Stoep
Amy
A
Hagopian
D000328:Adult; D000349:Africa; D000368:Aged; D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D032821:Commodification; D005069:Evaluation Studies as Topic; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D009276:Namibia / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011329:Prisoners / Q000523:psychology*; D011330:Prisons / Q000458:organization & administration*; D018907:Privacy; D057545:Social Stigma; D055815:Young Adult
D044966:Anti-Retroviral Agents
Africa; HIV; Namibia; antiretroviral therapy; medication adherence; prisoners