AIDS and Behavior

, Volume 10, Issue 4, pp 443–450

Perceptions About the Acceptability of Assessments of HIV Medication Adherence in Lilongwe, Malawi and Chennai, India

  • Steven A. Safren
  • N. Kumarasamy
  • Mina Hosseinipour
  • Meaghan M. Harwood
  • Irving Hoffman
  • Marybeth McCauley
  • Allan Jumbe
  • Christina Nyirenda
  • Matthew J. Mimiaga
  • Suniti Solomon
  • David Celentano
  • Kenneth H. Mayer
Article

DOI: 10.1007/s10461-006-9094-6

Cite this article as:
Safren, S.A., Kumarasamy, N., Hosseinipour, M. et al. AIDS Behav (2006) 10: 443. doi:10.1007/s10461-006-9094-6

Little research exists on acceptability issues related to assessments of adherence to ART in resource-poor settings. To help prepare for two large-scale, multisite ART intervention trials, this qualitative study of individuals in Chennai, India (49 men, 11 women; 33 taking ART, 27 not) and Lilongwe, Malawi (5 men, 5 women, all taking ART) examined potential limitations of different types of adherence assessments: an adherence questionnaire, a pill diary, a pillbox, an electronic pill cap, and a medication punch card. Many participants reported that the various assessments would be acceptable. Potential limitations included issues surrounding literacy, the desire to appease one’s medical provider, privacy and stigma, and “cheating.” These potential limitations are similar to the limitations of these assessments in Western settings. However, the data highlight the need to consider individual patient level concerns when assessing ART adherence in different cultural settings. Innovative ways of monitoring adherence while maintaining standardization across sites are required in multisite trials.

KEY WORDS:

antiretroviral therapy adherence developing countries qualitative research 

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Steven A. Safren
    • 1
    • 2
    • 10
  • N. Kumarasamy
    • 3
  • Mina Hosseinipour
    • 4
  • Meaghan M. Harwood
    • 1
  • Irving Hoffman
    • 4
  • Marybeth McCauley
    • 5
  • Allan Jumbe
    • 6
  • Christina Nyirenda
    • 6
  • Matthew J. Mimiaga
    • 1
    • 7
  • Suniti Solomon
    • 3
  • David Celentano
    • 8
  • Kenneth H. Mayer
    • 1
    • 9
  1. 1.Fenway Community HealthResearch and Evaluation DepartmentBostonUSA
  2. 2.Harvard Medical School/Massachusetts General HospitalBostonUSA
  3. 3.YRG CareCenter for AIDS Research and EducationChennaiIndia
  4. 4.University of North Carolina at Chapel HillSchool of MedicineChapel HillUSA
  5. 5.Family Health InternationalArlingtonUSA
  6. 6.Malawi Ministry of HealthKamuzu Central HospitalLilongweMalawi
  7. 7.Harvard UniversitySchool of Public HealthBostonUSA
  8. 8.Johns Hopkins UniversityBloomberg School of Public HealthBaltimoreUSA
  9. 9.Brown University/Miriam HospitalProvidenceUSA
  10. 10.Fenway Community Health, Research DepartmentBostonUSA

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