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What Time is it? Adherence to Antiretroviral Therapy in Ethiopia

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Abstract

This study assessed adherence to antiretroviral therapy (ART) among people living with HIV/AIDS in Ethiopia and explored the sociocultural context in which they relate to their regimen requirements. Data were collected through semi-structured in-depth interviews with 105 patients on ART and observations held at the study clinic. We analyzed data using both qualitative and quantitative methods. Our findings indicate that study participants are highly adherent to dose but less adherent to dose schedule. Strict dose time instructions were reported as stressful and unrealistic. The discrepancy between adherence to dose and dose schedule could be explained by time perception, difficulty with the strictness of medication regimens, or beliefs about dose timing adherence. Care providers should acknowledge the complexities of medication practices and engage in shared decision-making to incorporate patients’ perspectives and identify effective interventions.

Resumen

Se evaluó la adherencia a la terapia antirretroviral (TAR) entre personas que viven con el VIH/SIDA en Etiopía y se exploró el contexto en el cual estas personas se relacionan a las demandas de su régimen. Se recopiló datos e información a través de entrevistas semiestructuradas a profundidad con 105 pacientes recibiendo TAR y observaciones llevadas a cabo en la clínica del estudio. Se analizaron los datos utilizando tanto métodos cualitativos como cuantitativos. Los resultados indican que los participantes del estudio tienen un alto grado de adherencia a las dosis pero menos adherencia a los horarios prescritos. Seguimiento estricto de los horarios de tratamiento fue caracterizado como estresante y agobiante. La discrepancia entre la adherencia a la dosis y el horario de dosis podría explicarse en relación a la percepción del tiempo, la dificultad con la complejidad del régimen terapéutico, o las actitudes y creencias respecto a los horarios y las dosis indicadas. Los proveedores de servicios médicos deben tomar en consideración la complejidad del tratamiento y participar conjuntamente en la toma de decisiones para incorporar la perspectiva de los pacientes e identificar intervenciones efectivas.

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Acknowledgments

This study was supported by the department of Sociology and The Graduate School of Northwestern University, and by Grant Number T32HS000011 from the Agency for Healthcare Research and Quality.

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Authors and Affiliations

  1. Department of Health Services, Policy & Practice, Brown University, Providence, RI, USA

    Yordanos M. Tiruneh & Ira B. Wilson

  2. Center for Gerontology and Health Care Research, Brown University School of Public Health, Box G-S121-6, Providence, RI, 02912, USA

    Yordanos M. Tiruneh

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Correspondence to Yordanos M. Tiruneh.

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Tiruneh, Y.M., Wilson, I.B. What Time is it? Adherence to Antiretroviral Therapy in Ethiopia. AIDS Behav 20, 2662–2673 (2016). https://doi.org/10.1007/s10461-016-1322-0

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