Barriers to antiretroviral therapy adherence in rural Mozambique

BMC Public Health

Research Article

Kate Groh¹  Alberto Baptista²  Sten H Vermund³  Troy D Moon³  Alfredo Vergara⁴  Carolyn M Audet⁴  Mohsin Sidat⁵ 

[1] Department of Medicine, D-3100, Medical Center North, 37232-2358, Nashville, TN, USA;Department of Pediatrics, 2200 Children's Way, 37232, Nashville, TN, USA;Department of Preventive Medicine, Village at Vanderbilt, Suite 2100,1500 21st Avenue South, 37212, Nashville, TN, USA;Faculty of Medicine, University Eduardo Mondlane, PO Box 257, Maputo, Mozambique;Friends in Global Health, Avenida dos Trabalhadores N°424, Quelimane, Mozambique;Department of Preventive Medicine, Village at Vanderbilt, Suite 2100,1500 21st Avenue South, 37212, Nashville, TN, USA;Vanderbilt Institute for Global Health, 2525 West End Ave, Suite 750, 2525 West End Ave, 37203, Nashville, TN, USA;Ministry of Health, Av. Quelimane: Av. 1 de Julho, Predio deo Monte Giro, Quelimane, Mozambique;Faculty of Medicine, University Eduardo Mondlane, PO Box 257, Maputo, Mozambique;

关键词: HIV;    AIDS;    Mozambique;    antiretroviral therapy;    adherence;    compliance;    health care workers;    attitudes;    behaviors;    rural;    focus groups;   

DOI  :  10.1186/1471-2458-11-650

 received in 2011-04-08, accepted in 2011-08-16,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHIV is treated as a chronic disease, but high lost-to-follow-up rates and poor adherence to medication result in higher mortality, morbidity, and viral mutation. Within 18 clinical sites in rural Zambézia Province, Mozambique, patient adherence to antiretroviral therapy has been sub-optimal.MethodsTo better understand barriers to adherence, we conducted 18 community and clinic focus groups in six rural districts. We interviewed 76 women and 88 men, of whom 124 were community participants (CP; 60 women, 64 men) and 40 were health care workers (HCW; 16 women, 24 men) who provide care for those living with HIV.ResultsWhile there was some consensus, both CP and HCW provided complementary insights. CP focus groups noted a lack of confidentiality and poor treatment by hospital staff (42% CP vs. 0% HCW), doubt as to the benefits of antiretroviral therapy (75% CP vs. 0% HCW), and sharing medications with family members (66% CP vs. 0%HCW). Men expressed a greater concern about poor treatment by HCW than women (83% men vs. 0% women). Health care workers blamed patient preference for traditional medicine (42% CP vs. 100% HCW) and the side effects of medication for poor adherence (8% CP vs. 83% CHW).ConclusionsPerspectives of CP and HCW likely reflect differing sociocultural and educational backgrounds. Health care workers must understand community perspectives on causes of suboptimal adherence as a first step toward effective intervention.

【 授权许可】

Unknown   
© Groh et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.