title: Model of socio-cultural dimensions involved in adherence to antiretroviral therapy for HIV/AIDS in public health care centers in Chile.
abstract: In Chile, over 14,000 adults are living with HIV receive antiretroviral therapy (HAART). Adequate adherence to HAART has a major impact on survival. There is little consensus on the causes of poor adherence, due to the unique and diverse sociocultural parameters involved in the issue. The objective of this study was to identify sociocultural dimensions that serve as barriers or facilitators to HAART adherence among persons living with HIV/AIDS (PLHIV) in Chile. A qualitative study design, with an exploratory followed by a descriptive phase was conducted. The study population consisted of adults living with HIV/AIDS, with and without HAART. A theoretical sample was designed and three gender profiles defined: women, men, and transwomen. Data collection methods included in-depth interviews by anthropologists in seven public health care centers for PLHIV. The model of sociocultural dimensions indicated that factors associated with family, expectations, gender/sexuality, affect, relationship with HIV, HAART, work, social support and networks, and stigma and discrimination influenced adherence, with different patterns among profiles. This study found that adherence is a dynamic category. It is crucial to consider sociocultural factors in developing strategies to improve HAART adherence.
authors.affiliation: a Programa de Epidemiología, Escuela de Salud Pública , Universidad de Chile , Santiago , Chile.
authors.forename: Valeria
authors.initials: V
authors.lastname: Stuardo Ávila
authors.affiliation: a Programa de Epidemiología, Escuela de Salud Pública , Universidad de Chile , Santiago , Chile.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Manriquez Urbina
authors.affiliation: b Facultad de Odontología , Universidad de Chile , Santiago , Chile.
authors.forename: Valentina
authors.initials: V
authors.lastname: Fajreldin Chuaqui
authors.affiliation: a Programa de Epidemiología, Escuela de Salud Pública , Universidad de Chile , Santiago , Chile.
authors.forename: Julieta
authors.initials: J
authors.lastname: Belmar Prieto
authors.affiliation: c UNESCO , Santiago , Chile.
authors.forename: Victoria
authors.initials: V
authors.lastname: Valenzuela Santibáñez
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002677:Chile; D003151:Community Health Centers; D004651:Employment / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D005783:Gender Identity; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D008962:Models, Theoretical; D036301:Qualitative Research; D063508:Social Discrimination; D057545:Social Stigma; D012944:Social Support; D063106:Transgender Persons / Q000523:psychology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; adherence; gender; gender identity; sociocultural issues