Voices on adherence to ART in Ethiopia and Uganda: a matter of choice or simply not an option

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dc.creatorObua, Celestino
dc.creatorGusdal, Annelie K.
dc.creatorAnnelie, K.
dc.creatorWahlström, Rolf
dc.creatorTomson, Göran
dc.creatorPeterson, Stefan
dc.creatorEkström, Anna Mia
dc.creatorThorson, Anna
dc.creatorChalker, John
dc.creatorFochsen, Grethe
dc.date2012-02-02T11:06:01Z
dc.date2012-02-02T11:06:01Z
dc.date2009
dc.date.accessioned2018-09-04T12:32:25Z
dc.date.available2018-09-04T12:32:25Z
dc.descriptionThis paper explores HIV patients’ adherence to antiretroviral treatment (ART) in resource-limited contexts in Uganda and Ethiopia, where ART is provided free of charge. Qualitative semi-structured interviews were conducted with 79 patients, 17 peer counselors, and 22 providers in ART facilities in urban and rural areas of Ethiopia and Uganda. Interviewees voiced their experiences of, and views on ART adherence both from an individual and a system level perspective. Two main themes emerged from the content analysis: ‘‘Patients’ competing costs and systems’ resource constraints’’ and ‘‘Patients’ trust in ART and quality of the patient! provider encounters.’’ The first theme refers to how patients’ adherence was challenged by difficulties in supporting themselves and their families, paying for transportation, for drug refill and follow-up as well as paying for registration fees, opportunistic infection treatment, and expensive referrals to other hospitals. The second theme describes factors that influenced patients’ capacity to adhere: personal responsibility in treatment, trust in the effects of antiretroviral drugs, and trust in the quality of counseling. To grant patients a fair choice to successfully adhere to ART, transport costs to ART facilities need to be reduced. This implies providing patients with drugs for longer periods of time and arranging for better laboratory services, thus not necessitating frequent revisits. Services ought to be brought closer to patients and peripheral, community-based healthworkers used for drug distribution. There is a need for training providers and peer counselors, in communication skills and adherence counseling.
dc.descriptionThis study was made possible through support provided by the Swedish International Development Cooperation Agency, under the terms of contribution 72300310, the World Health Organization under an Agreement for Performance of Work OD-AP-07-00516 and by the Rational Pharmaceutical Management Plus Program, which is funded by the US Agency for International Development, under the terms of Cooperative Agreement number HRN-A-00-00-00016-00.
dc.identifierObua, C., Gusdal, A.K., Andualem, T., Wahlström, R., Tomson, G., Peterson, S., Ekström, A.M., Thorson, A., Chalker. J., Fochsen, G. (2009). Voices on adherence to ART in Ethiopia and Uganda: a matter of choice or simply not an option. AIDS Care, 21(11)
dc.identifier0954-0121
dc.identifierhttp://dx.doi.org/10.1080/09540120902883119
dc.identifierhttp://hdl.handle.net/10570/376
dc.identifier.urihttp://hdl.handle.net/10570/376
dc.languageen
dc.publisherRoutledge - Taylor & Francis
dc.subjectAdherence
dc.subjectAntiretroviral therapy
dc.subjectEast Africa
dc.subjectHIV/AIDS
dc.subjectQualitative research
dc.subjectCommunity-based healthworkers
dc.subjectUganda
dc.subjectEthiopia
dc.titleVoices on adherence to ART in Ethiopia and Uganda: a matter of choice or simply not an option
dc.typeJournal article, peer reviewed
dc.typeJournal article, preprint
dc.typeLearning Object
dc.typeTechnical Report
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