The document summarizes factors that influence adherence to highly active antiretroviral therapy (HAART) based on interviews with 13 HIV-positive individuals in South Africa. Key factors identified include: social support from family and friends which positively influences adherence; socioeconomic challenges like poverty, transportation costs, and unemployment which negatively impact adherence; and healthcare provider factors where public clinics raised privacy concerns but private providers offered more support and counseling. Disease symptoms and stigma also influence individual medication adherence. Overall, the study found social, economic, healthcare, personal, and treatment-related factors all play a role in levels of adherence.
Where’s the evidence that screening for distress benefits cancer patients?James Coyne
“The case against screening for distress.” A presentation delivered as part of an invited debate with Alex Mitchell at the International Psycho Oncology Conference, Rotterdam, November 7, 2013
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
Presentation by Avella Specialty Pharmacy & mScripts at Armada 2015 on improving medication adherence through mobile app technology. Learn about how Avella meets the challenges of medication non-adherence: http://www.avella.com/medication-adherence
Where’s the evidence that screening for distress benefits cancer patients?James Coyne
“The case against screening for distress.” A presentation delivered as part of an invited debate with Alex Mitchell at the International Psycho Oncology Conference, Rotterdam, November 7, 2013
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
Presentation by Avella Specialty Pharmacy & mScripts at Armada 2015 on improving medication adherence through mobile app technology. Learn about how Avella meets the challenges of medication non-adherence: http://www.avella.com/medication-adherence
Course Director Peter A. Lio, MD, and Robert Sidbury, MD, MPH, prepared useful Practice Aids pertaining to atopic dermatitis for this CME activity titled "Advances in the Management of Moderate to Severe Atopic Dermatitis: How Can We Address Unmet Medical Needs in Individual Patients to Optimize Long-Term Outcomes?" For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2VJqSFq. CME credit will be available until June 19, 2020.
Evidence-Based Practice Guidelines and Shared Decision Making: Conflicting or...Zackary Berger
How can we bridge physician guidelines, based on the best available evidence, and patient preferences? This workshop was given at the Society of General Internal Medicine 2015 Annual Meeting in Toronto, Canada.
Session Coordinator: Zackary Berger, MD, PhD
Additional Faculty: Michael J. Barry, MD, Kathleen Fairfield, MD, Leigh H. Simmons, MD, James Yeh, MD, Daniella A. Zipkin, MD, Dave deBronkart
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
Stop TB Partnership focus group session 10-20-17Bruce Thomas
The Arcady Group founder, Bruce Thomas, led the Stop TB Partnership's Focus Group Workshop On Digital Adherence Technologies. At this meeting, innovators such as Everwell Health (99DOTS), Wisepill Technologies (evriMED medication monitor), Keheala (SMS-based behavioral counseling) and SureAdhere Mobile Technology (V-DOT) were connected with representatives of key NGO implementers and country programs (including Zimbabwe, Philippines, Moldova, and South Africa) to discuss opportunities for experimentation and uptake of digital adherence technologies through TB REACH Wave 6 grants. Bruce and Ram Subbaraman shared new evidence and insights about the importance of treatment adherence to avoid TB relapse.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
Are Primary Care Clinicians Serving Low-Income Patients More Likely to Screen...asclepiuspdfs
Background: Women of all income levels experience domestic violence (DV). Primary health-care providers are able to screen women early and provide services or referrals; however, regular DV screening rarely occurs in the US. We investigated whether implicit bias based on patient population income level could be influencing provider practices in California. Methods: Data for this study were drawn from a self-administered survey conducted from October 2013 to March 2014. Providers (n = 152) were included if they worked in primary care and provided information on the predominant income of their patients. The survey included questions on provider demographics, screening practices, and number of female victims identified. Results: Providers serving low-income patient populations (LIPPs) or higher-income patient populations had equivalent training and knowledge about DV. However, DV screening practices (e.g., screening more often, at a younger age, and giving a screening question for DV) and outcomes (DV victims identified) varied significantly by patient population income level (P < 0.01). Working with low-income patients and engaging in universal screening practices both predicted more victim identification (P < 0.01). Conclusions: Implicit bias appears to influence clinicians’ screening practices, with those serving LIPPs being more likely to screen regardless of training or knowledge. If DV screening in primary care occurred more regularly, it would yield more detection of victims at all income levels. Training and self-reflection could combat implicit bias, as well as written policies and standardized procedures to encourage universal screening practices by clinicians irrespective of the income level of their patient populations.
Behavioral Health Staff in Integrated Care Settings | The Vital Role of Colla...CHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 06, 2019 | 3 p.m. EST
Experts in psychology, psychiatry and nursing will share ways in which they effectively utilize their roles at the top of their license to monitor and support high-risk patients. By examining these various roles, experts will address how you can effectively support integration at your health center to improve outcomes.
My team and produced a marketing mix through research in efforts to increase awareness, customers, and funds for a non-profit organization called HAART.
Most current highly active antiretroviral therapy (HAART) regimens for HIV-positive patients contain two nucleoside reverse transcriptase inhibitors (NRTIs) with either a Protease inhibitor (PIs) or a non-nucleoside reverse transcriptase inhibitors (NNRTI). Notwithstanding the regulatory guidelines recommending therapeutic drug monitoring (TDM) for these drugs, therapeutic failure is a very serious concern implying drug induced toxicity and more importantly viral rebound and viral resistance.
Single dose, steady state and dose ranging studies have all more or less demonstrated that there is a positive correlation between plasma concentrations and therapeutic effects of anti-retrovirals (ARVs). However, one of the main challenges still seems to be the target concentrations for these drugs and their relevant inhibitory quotient. In this talk, we are going to examine these issues along with bioanalytical challenges, drug-effect and drug –toxicity relationships and finally drug-drug interactions within different HAART regimes.
Course Director Peter A. Lio, MD, and Robert Sidbury, MD, MPH, prepared useful Practice Aids pertaining to atopic dermatitis for this CME activity titled "Advances in the Management of Moderate to Severe Atopic Dermatitis: How Can We Address Unmet Medical Needs in Individual Patients to Optimize Long-Term Outcomes?" For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2VJqSFq. CME credit will be available until June 19, 2020.
Evidence-Based Practice Guidelines and Shared Decision Making: Conflicting or...Zackary Berger
How can we bridge physician guidelines, based on the best available evidence, and patient preferences? This workshop was given at the Society of General Internal Medicine 2015 Annual Meeting in Toronto, Canada.
Session Coordinator: Zackary Berger, MD, PhD
Additional Faculty: Michael J. Barry, MD, Kathleen Fairfield, MD, Leigh H. Simmons, MD, James Yeh, MD, Daniella A. Zipkin, MD, Dave deBronkart
BRP Pharmaceuticals is a leader in physician dispensing services that provides instant medication to patients located in Burbank, CA. Visit: http://www.brppharma.com/
Stop TB Partnership focus group session 10-20-17Bruce Thomas
The Arcady Group founder, Bruce Thomas, led the Stop TB Partnership's Focus Group Workshop On Digital Adherence Technologies. At this meeting, innovators such as Everwell Health (99DOTS), Wisepill Technologies (evriMED medication monitor), Keheala (SMS-based behavioral counseling) and SureAdhere Mobile Technology (V-DOT) were connected with representatives of key NGO implementers and country programs (including Zimbabwe, Philippines, Moldova, and South Africa) to discuss opportunities for experimentation and uptake of digital adherence technologies through TB REACH Wave 6 grants. Bruce and Ram Subbaraman shared new evidence and insights about the importance of treatment adherence to avoid TB relapse.
Factors associated to adherence to DR-TB treatment in Georgia, Policy Brief (...Ina Charkviani
Tuberculosis (TB) is a widely spread disease globally that causes millions of people’s death worldwide. Treatment for TB is complex and usually involves taking several antibiotics at once for a long time (sometimes up to two years). Considering the severity of the treatment regimen, it becomes hard for the patients to adhere and complete proposed treatment and particularly for those who are infected with drug-resistant strain of TB. Poor adherence to treatment remains significant problem that prevents countries from obtaining high treatment success rates that is essential for health systems to control the epidemic and decrease spread of the disease. A new study from Georgia looks at adherence to treatment factors among drug resistant TB (DR-TB) patients and provides evidence that may help policy-makers develop effective strategies for improving treatment outcomes among DR-TB patients. The study findings might be helpful for other countries in the region where TB burden is also high.
Are Primary Care Clinicians Serving Low-Income Patients More Likely to Screen...asclepiuspdfs
Background: Women of all income levels experience domestic violence (DV). Primary health-care providers are able to screen women early and provide services or referrals; however, regular DV screening rarely occurs in the US. We investigated whether implicit bias based on patient population income level could be influencing provider practices in California. Methods: Data for this study were drawn from a self-administered survey conducted from October 2013 to March 2014. Providers (n = 152) were included if they worked in primary care and provided information on the predominant income of their patients. The survey included questions on provider demographics, screening practices, and number of female victims identified. Results: Providers serving low-income patient populations (LIPPs) or higher-income patient populations had equivalent training and knowledge about DV. However, DV screening practices (e.g., screening more often, at a younger age, and giving a screening question for DV) and outcomes (DV victims identified) varied significantly by patient population income level (P < 0.01). Working with low-income patients and engaging in universal screening practices both predicted more victim identification (P < 0.01). Conclusions: Implicit bias appears to influence clinicians’ screening practices, with those serving LIPPs being more likely to screen regardless of training or knowledge. If DV screening in primary care occurred more regularly, it would yield more detection of victims at all income levels. Training and self-reflection could combat implicit bias, as well as written policies and standardized procedures to encourage universal screening practices by clinicians irrespective of the income level of their patient populations.
Behavioral Health Staff in Integrated Care Settings | The Vital Role of Colla...CHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 06, 2019 | 3 p.m. EST
Experts in psychology, psychiatry and nursing will share ways in which they effectively utilize their roles at the top of their license to monitor and support high-risk patients. By examining these various roles, experts will address how you can effectively support integration at your health center to improve outcomes.
My team and produced a marketing mix through research in efforts to increase awareness, customers, and funds for a non-profit organization called HAART.
Most current highly active antiretroviral therapy (HAART) regimens for HIV-positive patients contain two nucleoside reverse transcriptase inhibitors (NRTIs) with either a Protease inhibitor (PIs) or a non-nucleoside reverse transcriptase inhibitors (NNRTI). Notwithstanding the regulatory guidelines recommending therapeutic drug monitoring (TDM) for these drugs, therapeutic failure is a very serious concern implying drug induced toxicity and more importantly viral rebound and viral resistance.
Single dose, steady state and dose ranging studies have all more or less demonstrated that there is a positive correlation between plasma concentrations and therapeutic effects of anti-retrovirals (ARVs). However, one of the main challenges still seems to be the target concentrations for these drugs and their relevant inhibitory quotient. In this talk, we are going to examine these issues along with bioanalytical challenges, drug-effect and drug –toxicity relationships and finally drug-drug interactions within different HAART regimes.
Newer drugs approved by US-FDA - Rxvichu!!!RxVichuZ
Hello friends...and readers...............
A moment of bliss and happiness.....................
This is my 20th ppt OVERALL!!
This ppt comprises THE NEWER DRUGS APPROVED BY US-FDA in 2016..............
CONTAINS PHARMACOLOGY OF 19 DRUGS...........................
I have included as many details as possible.................
This is PART-1 of my MEGA SEMINAR, which involves drugs APPROVED BY US-FDA in the years 2014, 2015 & 16..............
Do send ur reviews after scrutiny...............
Thanks for ur support, views, downloads, and wishes...from all around the world!!!
@rxvichu-alwz4uh! :)
On July 7, 2014, the Green Park Collaborative (GPC) of the Center for Medical Technology Policy (CMTP) and the Institute for Clinical and Economic Review (ICER) co-hosted a web conference to explore the evidence needed to demonstrate the effectiveness and value of new drugs to treat chronic hepatitis C (HCV) infection. Representatives from various stakeholder groups, including payers, patients, pharmaceutical industry, health technology assessment organizations, and regulatory bodies, presented and discussed this issue with a particular focus on:
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3. Strategies to efficiently generate the additional evidence.
Each of the invited speakers gave a brief presentation followed by a question and answer session at the end of the presentations. Audience members had an opportunity to submit questions through a chat feature. The conference was moderated by Dr. Sean Tunis, Founder
and CEO of CMTP. More than 200 participants, including a variety of subject matter experts and stakeholder representatives, attended the web conference.
Video and webinar summary available here: http://www.cmtpnet.org/featured-projects/green-park-collaborative/gpc-usa-meetings/webinars/hepatitis-c-drugs-evidence-to-demonstrate-effectiveness-value
Crohn’s Disease is a chronic inflammatory disease of the small and large intestine affecting more than 1 million U.S. citizens. According to the CDC, “The majority of Crohn’s patients will require surgery at some point during their lives.” Join us in this discussion of how medical cannabis can help manage Crohn’s symptoms and progression.
In order for the public to benefit from ground-breaking medical research, well-attended clinical trials are vital. We’ve put together five common myths about clinical trials, alongside measures to debunk them, giving participants the peace of mind they need to confidently join the clinical trial cause.
How to Bust Clinical Trial Myths and Increase Participation - mdgroupmdgroup
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The Undergraduate Research Opportunity Program’s Annual Spring Research Symposium is the culminating event for all students participating in UROP for the 2016-2017 academic year. The symposium will take place Wednesday, April 19th, 2017 from 9am - 5pm, at the Michigan Union
Hi52Hlth: Using Mobile Technology to Access Healthcare for TeensYTH
Hi52Hlth is a mobile application (app) created to engage adolescents and young adults in the search for resources in the Houston area. The app allows the user to search for locations of clinics and community organizations with directions, articles and videos on HIV/AIDS, ability to ask questions directly to health avatars ("Tiff" and "Ty"), PEP (Post-Exposure Prophylaxis) and PrEP (Pre-Exposure Prophylaxis) information, and a frequently asked questions section.
Why screeing cancer patients for distress will increase disparities in psycho...James Coyne
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This presentation brings awareness to transgender health care disparities and examines how practicing cultural competency can improve patient-physician relationships.
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INFORMATION SHARING AND SHARED DECISION MAKING IN CLINICAL .pptxSuryansh Agrawal
Important of information sharing is vital to safeguarding and promoting the welfare of children, young people and adults. The decisions about how much information to share, with whom and when, can have a profound impact on individuals' lives. It could ensure that an individual receives the right services at the right time
Similar to Factors that Influence Adherence to HAART - Naicker MH (20)
INFORMATION SHARING AND SHARED DECISION MAKING IN CLINICAL .pptx
Factors that Influence Adherence to HAART - Naicker MH
1. Factors that Influence
Adherence to Highly Active Antiretroviral
Therapy (HAART)
Author: Michaela Naicker
2nd UNISA Biennial Conference on Social Behavioural
Change towards Sustainable prevention of HIV, STIs
and TB in Africa
22-24 May 2013
2. Rationale for Study
• SA has the largest population of people living with HIV, the
largest number of people on ART and the largest public health
ART programme in the world.
• KZN province, the epicentre of the SA epidemic has the
highest prevalence and incidence rates in the country.
• The majority of HIV infected persons will eventually need ART
and near perfect (>95%) sustained adherence is critical for
optimal health outcomes.
• Sub-optimal adherence has potentially severe health
outcomes which may reduce treatment efficacy, cause drug
resistance [compromising available tx options] and increase
morbidity and mortality [susceptible to opportunistic
infections and cancers]
3. Research Problem and Objectives
The main objective of this study was to explore the factors that
influence adherence to HAART/ART.
The specific objectives were to gather in-depth information
about the following factors that influence HIV medication
adherence:
• Social and Economic Factors
• Health Care Provider and System Related Factors
• Condition or HIV Disease Related Factors
• Therapy Related Factors, and
• Person/Patient Related Factors
4. Key Questions
• What specific influences might social and economic factors
have on adherence to ART?
• What roles do health care providers and the health care
system play in facilitating adherence to ART?
• Does the medical condition of the HIV+ve person influence
ART adherence?
• Are there specific therapy related factors that might influence
adherence?
• What personal factors may influence adherence?
5. Methodology
• This research is a qualitative descriptive study to explore the
factors that influence adherence to HAART among persons
who access treatment in the greater Durban area.
• This qualitative study attempts to better understand
phenomena, the ‘what’, ‘how’ or ‘why’ questions that relate
to factors that influence behaviour to lifesaving medication.
6. Sampling Technique, Sample Size and Sampling Criteria
• Recruiting a sample willing and eager to share their
experiences of adherence posed a real challenge.
• An approach that demonstrated patience and perseverance as
well as an understanding of confidentiality and trust issues
enabled a small sample of 13 persons for this study.[HIV
infection is still highly stigmatised]
• The non-probability theoretical sampling technique was the
method of choice as this afforded the emergence of a rich
dense account of the factors that influence adherence. It is a
kind of purposive sampling.
7. Sampling, Sample Size and Sampling Criteria continued
• Eligible participants were over 21, were on treatment for at
least 2 years and appeared to be adhering optimally to their
medication.
• The 5 male participants accessed ART from their workplace
wellness programme and the 8 female participants accessed
treatment either using private, semi-private or public health
care in the greater Durban metropolis.
8. Data Collection and Data Analysis
• The In-depth Interview was the data collection method of
choice because they combine structure with flexibility, is
interactive and allows the use of questions to further explore
or clarify responses.
• In-depth interviews of one to one and a half hours were
conducted and the data was collected using a combination of
tape recording and detailed note taking.
• Data was analysed using thematic content analysis – this
involves identifying recurrent or common themes and
categorizing information under themes that emerged from
the data.
9. Ethical Considerations
• The research posed no harm to the participants and plans for
further counselling was available should the need arise.
• Informed consent ensured that the purpose, potential benefits and
risks and the reasons for inclusion were explained to enable
informed decision making. Participants were assured that they
could withdraw at any stage of the process.
• Participants names were changed to protect their identities and to
ensure confidentiality.
Limitations of this Study
• The intention of this study was to listen to the individual
experiences of persons on treatment and to gather rich
information about their experiences of adherence.
• The sampling method and small sample size means that the results
may not be generalised to the larger ART population.
10. Results
Social Support
• Social support emerged as a great motivator of adherence
behaviour. The social and emotional support received
from close family, friends, and colleagues positively
influenced adherence behaviour. “You need a support system
… you can’t be on your own …you need people’; ‘My family, my
kids make me take my meds, they help me’. Literature supports
this finding.
• Persons who accessed workplace, private and semi-
private health care were particularly expressive about the
supportive relationship they shared with their health care
providers. ‘I can open up to him [doctor] …talk man to man
… if he is not there I can go talk to her [occupational health
nurse]
11. Socio-Economic Factors
• Poverty, transport Cost (to and from clinics) and long travel
distances emerged as stumbling blocks to adherence
behaviour.
• Participants also shared that unemployment may lead to
depression and this causes persons to miss doses.
• Dependence on the social grant cause persons to default to
keep their CD4 <200 (to qualify for the grant).
• Needing someone to take care of children negatively
impacted on adherence.
• One participant was aware of people selling stocrin because
they needed money for their families.
• These findings are consistent with the literature.
12. Health Care Provider Factors
• Most participants shared positive experiences with their
Service Providers – receiving social, emotional and treatment
support for Adherence.
• The public sector attendees were generally satisfied but less
expressive about their relationship with their Service Provider.
• The Wellness clinic attendees and those who accessed Private
and Semi-Private Health Care were full of praise for the
quality of service experienced –spoke highly of the
encouragement and support received, and the open and
trusting relationship they shared with their service provider’s.
These health care providers were described as good listeners
who involved the persons in treatment decision making.
“passionate doctor takes longer and shows he is concerned”
“ doctor talks to me, he explains things to me , he has an open door policy”
13. • An area of grave concern mentioned by participants accessing
care at Public Clinics and Hospitals was the lack of
confidentiality and privacy regarding their HIV treatment
[which violates their right to confidentiality and privacy –
Patients’ Rights Charter].
“if you are waiting in that queue then you are waiting for ART”
• Persons in need of treatment were therefore reluctant to
access treatment at their local clinic or hospital because the
community would get to know their HIV positive status.
• Persons would therefore access treatment in another town or
clinic far from their home to ensure that no one recognises
them. Eg. Person lives in Tongaat but accesses ART miles away
in Greytown or Pietermaritzburg.
• Issues about compromising confidentiality were not abundant
in the literature.
14. HIV Disease Related Factors
• These factors refer to the symptoms or infections that an individual
may acquire or experience because of a weakening immune system
response caused by HIV on the body’s defence cells.
• Most of the participants felt sick, weak, tired and feverish more
often than not or they experienced weight loss or had rash which
could not be explained.
• Seven participants were diagnosed with opportunistic infections.
• The symptoms and opportunistic infections are all indicative of a
weak immune system response.
• The above is in accordance with the literature which states that HIV
infection in SA is often diagnosed late, when the CD4 count is well
below 200.
• Health outcomes are therefore poorer because Tx starts when the
immune system is quite compromised.
15. Treatment Factors
• All participants experienced side effects to some extent when
treatment was initiated.
• Responses to S/E were varied- from experiencing very little
S/E for a few days to really struggling with adverse S/E for
weeks/months.
• This demonstrates that people react very differently to similar
prescribed medication – indicating the importance of
individual monitoring, information and education for persons
on treatment.
• The benefits of ART far outweigh the risks; ART is well
tolerated by the majority of persons on treatment and most
side effects are manageable.
16. ‘Patient’/Person Factors than Influence Adherence
Positive Attitude and Strong Beliefs about the value of ART
• All participants were determined to adhere optimally because they
believed in their tx and wanted to live healthy lives.
Stigma, Secrecy, Discrimination, Disclosure and Denial
• Only one participant was completely open about her status.
• All others disclosed to at least someone whom they could trust –
close family, friends. Disclosure increases adherence behaviour.
• Most shared that hiding to take medication negatively influences
adherence.
• Stigma is of the utmost concern because it is both cause and effect
of secrecy and denial – persons claim that they have less
stigmatised diseases such as cancer, thus preventing them from
accessing life-saving ART.
• Two participants shared that stigma associated with HIV is not as
bad as before.
17. Education and Knowledge about HIV/AIDS
• Participants shared that knowledge and understanding about
the importance of taking ART as prescribed enhances
adherence behaviour.
Traditional Medicine
• All Participants were careful about not using traditional
medicine with ART because of the information and knowledge
they received about ART.
• One Participant accessed ART as a last resort because
traditional medicine was not helping his illness.
• Participant’s reported that they were aware of people in need
of ART who opt for traditional medicine only.
18. Normalisation of HIV/AIDS
• Most of the Participants accepted HIV infection just like any
other illness or disease.
• They have an illness, just like any other chronic illness eg.
[diabetes, hypertension].
• Participants felt that they can live a normal life if they take
their medication as prescribed.
• Normalising HIV/AIDS may be the key to ending stigma, denial
and the shame associated with HIV/AIDS.
Motivating Factors –Parenthood and Responsibility
• Participants with young families shared that their motivation
for adhering and staying healthy was because of their
responsibility as a parent, a provider and a spouse.
• The spoke passionately about their responsibilities and were
determined to stay healthy.
19. Lifestyle Factors
• Most Participants led a quiet life with their families and one
participant stated that staying in one place makes taking
medication much easier as compared to moving around a lot.
• Most of the Participants lived a healthy lifestyle - eating
healthily, exercising.
• Participants also shared that being organised and responsible
helped adherence.
Religion and Spirituality
• For 3 participants God and their strong religious beliefs
helped them cope with living with HIV and with medication
adherence.
20. Forgetfulness
• All Participants shared that at some point in their lives they
may have forgotten to take their medication.
• All shared that they knew exactly what to do if they forgot to
take their ART because they understood the consequences of
forgetting.
• Some used reminders eg. pocket alarm,TV programme, cell
phone.
Self-Efficacy
• Self –Efficacy can be described as a person’s belief in his/her
ability to take their medication as prescribed and this
positively influences adherence behaviour.
• Most participants alluded to self-efficacy - Bob’s ‘self belief’,
Mel’s ‘intrinsic belief’, which is supported by literature.
21. Health Improvement – Ambiquous
• One person shared that some people on ART take their
treatment only when they are ill and then stop taking
treatment when they feel well.
• Therefore adherence counselling at this stage of tx is critical if
optimal adherence is to be maintained.
• This reiterates the need for ongoing counselling and
education throughout the different periods to better
understand the challenges that come with lifelong treatment.
22. Interesting Observations from this study
• Despite the HIV/AIDS Awareness /Know your status
campaigns, all the participants accessed ART only when they
presented with an opportunistic infections [TB,PCP] or when
the disease impacted severely on daily functioning.
• The Workplace attendees alluded to exceptional care at their
Wellness clinic – no HIV queue, privacy and confidentiality
and supportive caring staff – yet those participants still only
accessed Tx when their HIV disease was impacting negatively
on their ability to perform their work related tasks or when
they presented with an opportunistic infection.
23. • All participants accessed ART when their CD4 counts were
below 100 (which shows that we are still battling to get
people to test early and to access treatment early – before
immune system compromise).
• Most people are not aware of their Health Care Rights as
outlined in the Patients’ Rights Charter.
24. Conclusion
• Life long sustained perfect[>95%]adherence rates poses a real
challenge to persons on ART. Typical adherence rates over
prolonged periods of time are in the range 50 -75%.
• The benefits of sustained near perfect adherence are
enormous:
- Persons on treatment can live relatively normal long healthy
lives.
- Negligible viral load positively contributes to prevention.
- Public ART roll-out is not compromised because of decreased
resistance with increase in adherence.
- Persons becomes less susceptible to opportunistic infections
and cancers.
25. • This study recognises the value of the subjective experiences
of persons on treatment with regard to their ability to take
their medication as prescribed.
• Information gleaned enables a broader and more in-depth
understanding of the factors that may influence adherence
behaviour.
• Emphasis on the unique subjective experiences may enable
greater insight into strategies that enhance adherence
behaviour.
26. .
Accessing treatment early – before the immune system is
compromised still poses a challenge that needs to be
addressed.
As persons live longer because of ART, ongoing research will
need to explore the effects of treatment over time, the effects
of treatment at different life stages as well as the ability to
sustain high levels of adherence over a lifetime.
Thank you