The Qualitative Antiretroviral Adherence Study in Five Sites in KwaZulu-Natal
Funded by USAID
This research project was undertaken by Ms Sibongile Mkhize and Mr Siyabonga Nzimande in partnership with Mr Stanley Yoder of MEASURE Evaluation, and funded by USAID. The study sought to clarify factors affecting adherence to HIV therapy, and also to develop a set of tools, that could be used to collect and share information on patients’ experiences of taking antiretrovirals, which was intended to be useful to antiretroviral treatment (ART) managers in understanding the strategies that patients could use to achieve high adherence.
The findings revealed that the two keys factors relating to high adherence were: having a committed and informed treatment supporter, and a willingness to disclose their HIV status to family, friends or close associates. Individuals still in an ART programme had managed to deal with their side effects. Patients who stopped taking their ARVs were particularly vulnerable both socially and economically
as very few of them had an adequate and dependable source of income and few sources of social support. ART patients with a TB history were treated as a separate group to explore whether they had benefited from adhering to a TB treatment regimen in their adherence to ART. The study did not find evidence to support this expectation. The findings indicated that achieving high adherence,
judged by not missing doses, depended less on a particular strategy for remembering when to take ARVs than on how that strategy was maintained within a household. They suggested that ART programmes should examine how individuals are situated within their household when considering the assistance patients need to maintain high adherence.