Post-ART Symptoms Were Not the Problem: A Qualitative Study on Adherence to ART in HIV-Infected Patients in a Mozambican Rural Hospital
The
objective of this qualitative study was to explore how clinical symptoms may
affect adherence to antiretroviral therapy (ART) in HIV patients, and to
explore factors, perceptions and attitudes related to adherence to therapy.
Most
participants (73%) knew that AIDS is a chronic disease and that ART does not
cure it. Nine participants (18%) were non-adherent at some point and two (4%)
abandoned ART. All participants but five reported having symptoms after
starting ART, mainly attributed to pills needing time to act and body's
reaction to the treatment. In spite of the perceived severity of the symptoms,
only two people reported they discontinued the treatment due to symptoms.
Almost all participants reported feeling comfortable with the HIV clinic
organization and procedures, but afraid of staff being hostile if they did not
follow the rules or if the health worker visited their home. Family was one of
the most important source of support according participants. Almost all participants
with children said that a decisive factor to follow the treatment was the
desire to be able to look after them.
Experiencing
symptoms after starting treatment was not a barrier to adherence to ART.
Factors related to adherence included control measures set up by the health
facility (exhaustive follow up, support, information) and family and community
support. Indirect ART-related expenses did jeopardise adherence.
By: Maixenchs M1, Boene H2, Anselmo R2, Mindu C2, Alonso P3, Menéndez C3, Macete E2, Pool R4, Letang E5, Naniche D3, Munguambe K6.
- 1Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique; ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
- 2Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique.
- 3ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
- 4ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.
- 5ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Swiss Tropical and Public Health Institute, Basel, Switzerland.
- 6Centro de Investigação em Saúde de Manhiça (CISM), Manhiça, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
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