TY - JOUR
T1 - A Qualitative Study of Patient Motivation to Adhere
to Combination Antiretroviral Therapy in South Africa.
AU - Gray, Debra
AU - van Loggerenberg, Francois
AU - Gengiah, Santhanalakshmi
AU - Kunene, Pinky
AU - Gengiah, Tanuja N.
AU - MClinPharm, null
AU - Naidoo, Kogieleum
AU - Grant, Alison D.
PY - 2015/2/18
Y1 - 2015/2/18
N2 - Taken as prescribed, that is, with high adherence, combination antiretroviral therapy (ART) has changed HIV
infection and disease from being a sure predictor of death to a manageable chronic illness. Adherence, however,
is difficult to achieve and maintain. The CAPRISA 058 study was conducted between 2007 and 2009 to test the
efficacy of individualized motivational counselling to enhance ART adherence in South Africa. As part of the
overall trial, a qualitative sub-study was conducted, including 30 individual interviews and four focus group
discussions with patients in the first 9 months of ART initiation. Data were inductively analyzed, using thematic
analysis, to identify themes central to ART adherence in this context. Four themes emerged that characterize the
participants’ experiences and high motivation to adhere to ART. Participants in this study were highly motivated
to adhere, as they acknowledged that ART was ‘life-giving’, in the face of a large amount of morbidity
and mortality. They were further supported by techniques of routine remembering, and highlighted the importance
of good social support and access to supportive healthcare workers, to their continued success in
negotiating their treatment. Participants in the current study told us that their adherence motivation is enhanced
by free accessible care, approachable and supportive healthcare workers, broad social acceptance of ART, and
past first-hand experiences with AIDS-related co-morbidity and mortality. Programs that include specific attention
to these aspects of care will likely be successful in the long term.
AB - Taken as prescribed, that is, with high adherence, combination antiretroviral therapy (ART) has changed HIV
infection and disease from being a sure predictor of death to a manageable chronic illness. Adherence, however,
is difficult to achieve and maintain. The CAPRISA 058 study was conducted between 2007 and 2009 to test the
efficacy of individualized motivational counselling to enhance ART adherence in South Africa. As part of the
overall trial, a qualitative sub-study was conducted, including 30 individual interviews and four focus group
discussions with patients in the first 9 months of ART initiation. Data were inductively analyzed, using thematic
analysis, to identify themes central to ART adherence in this context. Four themes emerged that characterize the
participants’ experiences and high motivation to adhere to ART. Participants in this study were highly motivated
to adhere, as they acknowledged that ART was ‘life-giving’, in the face of a large amount of morbidity
and mortality. They were further supported by techniques of routine remembering, and highlighted the importance
of good social support and access to supportive healthcare workers, to their continued success in
negotiating their treatment. Participants in the current study told us that their adherence motivation is enhanced
by free accessible care, approachable and supportive healthcare workers, broad social acceptance of ART, and
past first-hand experiences with AIDS-related co-morbidity and mortality. Programs that include specific attention
to these aspects of care will likely be successful in the long term.
KW - patient motivation
KW - Combination Antiretroviral Therapy
KW - 2020
U2 - 10.1089/apc.2014.0293
DO - 10.1089/apc.2014.0293
M3 - Article
VL - 29
SP - 299
EP - 306
JO - AIDS Patient Care and STDs
JF - AIDS Patient Care and STDs
SN - 1087-2914
IS - 5
ER -