Faculty of Health Science

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Browsing Faculty of Health Science by Subject "Adherence"

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    Correlates of Missed HIV Appointments in Low-resource Settings: a Study from Uganda
    (Routledge Taylor and Francis, 2021-03-31) Vancampfort, Davy; Byansi, Peter; Ward, Philip B; Mugisha, James
    Alarming reports of antiretroviral treatment failure have recently emerged in sub-Saharan Africa. The onset of virologic failure has multiple causes but suboptimal treatment adherence is one of the leading causes. This study aimed to explore correlates of adherence to HIV appointments in community care patients living with HIV/ AIDS in Uganda. Two hundred and ninety-five people living with HIV (median age 37.0 years; interquartile range 16.0; female 67.8% [n = 200]) reported whether they had missed any of their four-weekly appointments during the past 24 weeks. They also completed the Internalized AIDS-Related Stigma Scale, Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, the Alcohol-Use Disorders Identification Test, and the Physical Activity Vital Sign. Thirty-three (11.2%) patients missed at least one of their six scheduled appointments in the 24-week period. The adjusted odds ratio for missing at least one of six appointments was 3.03 (95% CI: 1.21–8.43, p = 0.01) for those who were physically inactive, and 2.29 (95% CI: 0.93–5.63, p = 0.046) for those with depression. Targeting future rehabilitation studies for PLHIV around feelings of depression and around physical inactivity could be important in achieving optimal HIV treatment adherence.
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    A qualitative exploration of the psychosocial factors affecting antiretroviral therapy adherence among HIV infected young adults in Eastern Uganda
    (medRxiv preprint, 2023-02-07) Twekambe, Easton; Epuitai, Joshua; Kawala, Enid Kagoya; Namanya, Vian; Ayikobua, Emmanuel Tiyo; Obakiro, Samuel Baker; Napyo, Agnes; Kiyimba, Kenedy
    The use of anti-retroviral therapy (ART) in management and prevention of HIV/AIDS epidemic is a globally accepted strategy. In Uganda, despite the efforts to increase uptake of ART, adherence remains a huge challenge. This study, therefore, was conducted to explore psychosocial factors which influenced non-adherence to ART among young adults in Eastern Uganda. This was an exploratory qualitative study conducted at the ART clinic of Mbale Regional Referral Hospital. A total of in-depth interviews with young adults who had defaulted from taking ART drugs were conducted. Also, five key-informant interviews were conducted among the healthcare workers in the hospital. Thematic analysis approach was followed to analyze the data using NVIVO software (version 11). Non-adherence to ART was perceived to result from poor social support, poor coping mechanisms, unpredictable and busy work schedules, poverty, incompatible religious beliefs and practices. The poor social support factors included poor caregiver support, non-disclosure of HIV status, stigma and discrimination while factors linked to poor coping mechanisms included alcohol and substance abuse, psychosocial stress, depression, forgetfulness and feelings of self-hatred. Poverty limits access to treatment and basic needs including transportation to health facilities. Long waiting time at the ART clinic was the healthcare system factor which was thought to cause non-adherence among young adults Non-adherence to ART at Mbale Regional Referral Hospital in Eastern Uganda is attributed to various psychosocial factors such as stigma and discrimination, mental health problems, work related problems and low socio-economic status, religious beliefs and poor knowledge, long waiting time in ART clinic and poor family support. Psychosocial counselling should therefore target the perceived causes of ART non-adherence so as to improve the adherence /compliance to ART.