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Factors associated with poor adherence to anti-retroviral therapy in patients attending a rural health centre in South Africa

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Abstract

South Africa has a very high HIV disease burden and proper patient adherence to anti-retroviral therapy (ART) is crucial in achieving optimal treatment outcomes. Factors influencing adherence include demographic and psychosocial factors, medication-related issues and other patient-related matters. This study was carried out in order to determine factors associated with poor compliance to anti-retroviral (ARV) medications in a rural setting. This interview-based descriptive and analytical study was carried out in a health centre where 168 patients who received ARVs were interviewed with pre-structured questionnaires, which covered various important compliance-related aspects. The results showed that 37.5% of the patients were non-adherent. Amongst men, poor adherence was seen in those who were single (48.9%), with tertiary education (60%), in those who consumed alcohol regularly (47.1%) and in those who were unemployed (56.1%). Higher rates of non-adherence in women was associated with being single (36.5%) and in those who used alcohol (60.7%). Medication-related adverse effects were reported in 47% of patients, notably, neuropathy, headache, nausea, loss of memory, diarrhoea and fatigue. Common reasons for missing doses were: being away from home (57.1%), simply forgot (41.3%), side effects (50.8%) and being too busy (49.2%). Poor adherence to ART is an important concern relating to HIV management in our setting and needs to be addressed with more patient-oriented interventions.

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Acknowledgements

The authors would like to acknowledge the Ngangelizwe Health Centre staff, patients who volunteered for the study and the Department of Community Medicine, Faculty of Health Sciences, Walter Sisulu University.

Funding

No funding was required for this study.

Conflicts of interests

No conflicts of interests are declared.

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Authors and Affiliations

  1. Department of Medical Microbiology, Faculty of Health Sciences, Walter Sisulu University, Pvt. Bag X1, Mthatha, ECP, South Africa

    V. G. Bhat

  2. MBChB-3 COBES Group, Walter Sisulu University, Mthatha, ECP, South Africa

    M. Ramburuth, M. Singh, O. Titi, A. P. Antony, L. Chiya, E. M. Irusen, P. P. Mtyapi, M. E. Mofoka, A. Zibeke, L. A. Chere-Sao, N. Gwadiso, N. C. Sethathi, S. R. Mbondwana & M. Msengana

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  1. V. G. Bhat
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Correspondence to V. G. Bhat.

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Bhat, V.G., Ramburuth, M., Singh, M. et al. Factors associated with poor adherence to anti-retroviral therapy in patients attending a rural health centre in South Africa. Eur J Clin Microbiol Infect Dis 29, 947–953 (2010). https://doi.org/10.1007/s10096-010-0949-4

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  • DOI: https://doi.org/10.1007/s10096-010-0949-4

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