Socio-demographic factors affecting adherence to antiretroviral therapy in a wellness centre in South Africa
Abstract
Patients’ non-adherence to antiretroviral treatment remains a public health challenge in most
developing countries, including South Africa. Although the Government avails all efforts to
ensure ART availability in hospitals around the country, non-adherence to ART is still a major
concern. Accordingly, quantitative and qualitative data were collected from patients enrolled
into treatment between 2010 and 2014. These mixed methods were applied at a wellness
centre in the Mpumalanga province of South Africa to examine the effect of selected social
and demographic factors on patients’ antiretroviral therapy treatment. The sample size of the
quantitative approach was 777 patients enrolled on ART, of which 486 patients made up the
group of patients who have not defaulted, while 291 patients made up the group of defaulting
patients. On the other hand, the qualitative survey covered 20 patients, including 10 defaulters
and 10 non-defaulters, to ascertain the psychosocial factors influencing ART uptake at the
Piet Retief Wellness Centre.
The quantitative approach, therefore, indicated that the patients started defaulting from the
first month of initiating treatment and all patients ended defaulting by the 55 months. In terms
of the socio-demographic predictors, while there was no statistically significant association
between gender and marital status on the one hand and treatment default on the other, age
was significantly and positively associated with treatment default. Also, educated patients
were less likely to default on treatment compared to their less educated counterparts.
Similarly, employed patients and patients who resided in urban areas were more likely to
default on treatment. Subsequently, the findings from the qualitative analysis revealed that
poor service quality negatively influence ART uptake, adverse effects from ART negatively
affect ART uptake and barriers / challenges to ART uptake as faced by patients, such as
financial, psychological and physical barriers negatively affect the uptake of ART.
Interventions aiming at dealing with these issues as identified and discussed in the study have
to be developed and put in place to ensure success in the administration of ART in
Mpumalanga province of South Africa.
In conclusion, interventions that will support people on ART in wellness centres around the
country should be developed and strengthened. Accordingly, all organizations should develop
an HIV and AIDS workplace policy, that the Government of South Africa through the National
Department of Health monitor and emphasize the importance of ensuring ART quality services
in all HIV clinics around the country and finally interventions in terms of finances to meet the
escalating food and transport demand for people on ART should be put in place to ensure that
adherence is for a lifetime. There is also a need to undertake further research on sociodemographic
and psychosocial factors affecting patients’ adherence to ART utilizing the
survival analysis, focusing on all wellness centres in South Africa.
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