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    Factors Influencing Adherence to Antiretroviral Treatment among Adults Accessing Care from Private Health Facilities in Malawi

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    Research articles (613Kb)
    Publication Date
    2019
    Authors
    Chiramb, Lusungu
    Valet, Martha
    Kamanga, Tifiness Mary Banda
    Nyondo-Mipando, Alinane Linda
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    (4 total)
    Type
    Article, Journal
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    Citation

    Chirambo, L., Valeta, M., Banda Kamanga, T.M. et al. Factors influencing adherence to antiretroviral treatment among adults accessing care from private health facilities in Malawi. BMC Public Health 19, 1382 (2019). https://doi.org/10.1186/s12889-019-7768-z

    Abstract/Overview

    Background: Private health facilities are increasingly being recognized as the neglected partner in the provision of HIV services. The non-adherence rate in the study sites ranged from 19 to 22%. This study explored the factors associated with non-adherence from antiretroviral therapy (ART) among adult patients accessing ART services at two privately owned urban health facilities in Malawi. Methods: We conducted a descriptive qualitative approach employing in-depth interviews among adults who either defaulted or were retained in HIV care in two privately owned facilities in Malawi from March to July 2017. We purposively selected participants and interviewed a total of 6 ART providers and 24 ART clients. Data were analyzed manually using a thematic approach. Results: Overall, participants identified four facilitators for retention in care and four broad categories of barriers namely individual, psychological, drug related and human resource related factors. The factors that facilitated retention in care included follow up visits after missing a visit, adequate information education and counseling, and supportive relationships. Conclusion: The main reason for defaulting from antiretrovirals (ARVs) was fear of disclosing an HIV status to avert potential stigma and discrimination. In implementing ART clinics due consideration and strategies need to be adopted to ensure that privacy and confidentiality is preserved. Although adoption of all the key Malawi Implementing strategies like expert clients and a guardian may optimize retention in care, there is need for prior analysis of how those may lead to unintended disclosure which inadvertently affects adherence. Furthermore, private facilities should orient their clients to the public facilities within the catchment area so that clients have an option for alternative access to HIV care in the event of financial constraints.

    Subject/Keywords
    Non-adherence; Antiretroviral therapy (ART); HIV care; Information education and counseling; HIV
    Further Details

    © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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    BMC Public Health
    Permalink
    https://repository.amref.ac.ke/handle/123456789/554
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    • General - GEN [366]

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