Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa

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dc.contributor.authorBarnett, W
dc.contributor.authorPatten, G
dc.contributor.authorKerschberger, B
dc.contributor.authorConradie, K
dc.contributor.authorGarone, D B
dc.contributor.authorVan Cutsem, G
dc.contributor.authorColvin, C K J
dc.date.accessioned2021-10-08T07:17:49Z
dc.date.available2021-10-08T07:17:49Z
dc.date.issued2013
dc.description.abstractBackground. The recent scale-up of antiretroviral therapy (ART) coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART.Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers.Methods. Research was conducted at a large primary care tuberculosis (TB)/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11), in-depth interviews with patients (n=10) and a Photovoice workshop (n=11). Responses and photographs were coded by content; data were transformed into variables and analysed accordingly.Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic.Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence.
dc.identifier.apacitationBarnett, W., Patten, G., Kerschberger, B., Conradie, K., Garone, D. B., Van Cutsem, G., & Colvin, C. K. J. (2013). Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa. <i>Southern African Journal of Hiv Medicine</i>, 14(4), 166 - 177. http://hdl.handle.net/11427/34827en_ZA
dc.identifier.chicagocitationBarnett, W, G Patten, B Kerschberger, K Conradie, D B Garone, G Van Cutsem, and C K J Colvin "Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa." <i>Southern African Journal of Hiv Medicine</i> 14, 4. (2013): 166 - 177. http://hdl.handle.net/11427/34827en_ZA
dc.identifier.citationBarnett, W., Patten, G., Kerschberger, B., Conradie, K., Garone, D.B., Van Cutsem, G. & Colvin, C.K.J. 2013. Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa. <i>Southern African Journal of Hiv Medicine.</i> 14(4):166 - 177. http://hdl.handle.net/11427/34827en_ZA
dc.identifier.issn1608-9693
dc.identifier.issn2078-6751
dc.identifier.ris TY - Journal Article AU - Barnett, W AU - Patten, G AU - Kerschberger, B AU - Conradie, K AU - Garone, D B AU - Van Cutsem, G AU - Colvin, C K J AB - Background. The recent scale-up of antiretroviral therapy (ART) coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART.Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers.Methods. Research was conducted at a large primary care tuberculosis (TB)/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11), in-depth interviews with patients (n=10) and a Photovoice workshop (n=11). Responses and photographs were coded by content; data were transformed into variables and analysed accordingly.Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic.Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence. DA - 2013 DB - OpenUCT DP - University of Cape Town IS - 4 J1 - Southern African Journal of Hiv Medicine LK - https://open.uct.ac.za PY - 2013 SM - 1608-9693 SM - 2078-6751 T1 - Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa TI - Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa UR - http://hdl.handle.net/11427/34827 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34827
dc.identifier.vancouvercitationBarnett W, Patten G, Kerschberger B, Conradie K, Garone DB, Van Cutsem G, et al. Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa. Southern African Journal of Hiv Medicine. 2013;14(4):166 - 177. http://hdl.handle.net/11427/34827.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouthern African Journal of Hiv Medicine
dc.source.journalissue4
dc.source.journalvolume14
dc.source.pagination166 - 177
dc.source.urihttps://dx.doi.org/10.4102/sajhivmed.v14i4.51
dc.subject.otherperceived barriers
dc.subject.otherART adherence
dc.subject.otherantiretroviral therapy
dc.subject.othersecond-line ART
dc.subject.otherfailure
dc.subject.otherPublic aspects of medicine
dc.subject.otherRA1-1270
dc.titlePerceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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