Patients’ knowledge and beliefs about antiretroviral treatment and factors associated with adherence in Mpumalanga Province, South Africa

Abstract

Background: Antiretroviral treatment (ART) improves the prognosis and quality of life for HIV patients by reducing the rate of disease progression and mortality. Although ART has been available in public health centres in South Africa since 2003, adherence to treatment still remains a challenge. To date, no study has investigated adherence and the factors that influence adherence to ART in rural settings in Mpumalanga Province.Objective: This study described adherence to, knowledge and beliefs about ART and other factors associated with adherence amongst patients registered at Shongwe Hospital in Nkomazi Local Municipality.Method: A cross-sectional survey of 184 randomly selected patients on ART between ages of 15 and 65 years was conducted.Results: The respondents completed a questionnaire on self-reported adherence, knowledge and beliefs about ART and other factors associated with adherence. The majority of the respondents were female (71.2%) and unemployed (83.7%). Most respondents reported optimal ART adherence (taking 95% or more of their medication as prescribed) over the past two (92.4%) and seven (84.2%) days, respectively. The level of knowledge about ART was high and most reported positive beliefs about the effectiveness of ART. However, slightly more than half (53.3%) believed that ART was harmful for the body. The most commonly-reported reasons for missing dosages were forgetfulness, business of the daily routine, having visitors, ‘visiting a bar’ and sleeping away from home.Conclusion: Although, the study found that most ART patients at Shongwe Hospital reported optimal adherence initially, the reasons for missing dosages, some incorrect knowledge and beliefs need to be addressed to ensure long-term adherence and persistence in care. Agterground: Antiretrovirale (ARV) behandeling verbeter die prognose en lewenskwalitiet van pasiënte wat besmet is met MIV, deur ‘n remmende effek op die ontwikkeling van VIGS te bewerkstellig. Alhoewel ARVbehandeling reeds sedert 2003 in openbare gesondheidsentrums in Suid Afrika beskikbaar was, bly die volgehoue en stiptelike navolging van die behandelingsplan ‘n grootse uitdaging vir pasiënte. Daar is egter min navorsing oor die faktore wat navolging van ARV behandeling deur pasiënte in landelike gebiede in Mpumalanga gedoen.Doelwitte: Hierdie studie ondersoek pasiënte se kennis, houdings en ander faktore wat die navolging van ARV behandeling beïnvloed by Shongwe-hospitaal in die Nkomazi distrik in Mpumalanga.Metode: ‘n Bestekopname van 184 pasiënte, tussen die ouderdomme van 15 en 65 jaar, wat ARV behandeling ontvang is gedoen. Hulle is lukraak gekies en het ‘n vraelys voltooi rakende hul kennis en oortuigings ten opsigte van ARV-middels, asook die faktore wat die stiptelike gebruik van die middels beïnvloed.Resultate: Die steekproef het hoofsaaklik uit vroue (71.2%) bestaan, en die meerderheid was werkloos (83.7%). Die meeste van die deelnemers het aangedui dat hulle hul ARV-medikasie die vorige twee dae (92.4%) en sewe dae (84.2%) grotendeels (ten minste 95% van medikasie) volgens voorskrif geneem het. Die meerderheid van die studie deelnemers het redelike kennis van en positiewe houdings teenoor ARV-behandeling getoon. Vergeetagtigheid, die besigheid van normale daaglikse roetine, die ontvang van besoekers, besoeke aan kroeë asook uitslaap was die redes wat aangevoer is vir vernalating om medisyne te neem.Gevolgtrekking: Alhoewel, die meeste pasiënte in hierdie studie aanvanklik redelik goed gevaar het met die navolging van die behandelingsplan, moet die probleme wat ervaar is met die neem van medikasie aangespreek word om lang-termyn navolging van behandeling en retensie te bewerkstellig.