Applying a Social Behavioral Model of medication adherence to educate HIV-infected patients to achieve a better therapeutic outcome in a public sector setting

[Speaker] Lucky Norah Katende-Kyenda:1
1:General Medicine and Pharmacology, Walter Sisulu University, South Africa

Access to antiretroviral therapy (ART) has increased worldwide. The prevalence of HIV-infection especially in the youth has increased, so information regarding ART-adherence and strategies to address nonadherence are urgently needed in middle-and low-income countries. Factors associated with poor-adherence to ART were determined and an Information-Motivation-Behavioral Skills (IMB) model in ART adherence was applied among HIV-infected attending a public primary health Care Clinic, to achieve a better therapeutic outcome.
Data were collected from 86 HIV-infected during a descriptive cross-sectional study using a standardized-questionnaire and face-to-face-exit interviews. Pill-counts technique was performed and adherence-rate of ≥95% considered acceptable. Data were analyzed using SPSS 22.0. Univariate-factors associated with poor-adherence to HAART were assessed using ANOVA and p≤ 0.05 considered statistically significant.
Of 86 HIV-infected, 63(73.3%) were females and 23(26.7%) males and were enrolled on HAART for 35.5(±31.8) months ranging from 1-137 months with mean age (±SD) of 35.6(±9.6) years. Of these, 27(31.40%) and 25(29.07%) were on WHO stages 2 and 3 respectively. Adherence-rate computed from 32 patients revealed 23(71.9%) having poor adherence-rate.
Participants (85) that responded on the level of knowledge about HAART in terms of: names of tablets, correct dose, when to take their tablets and knowing their adverse effects had no influence on adherence. Of the 23 non-compliant, 10(40%) gave the reason of drugs non-availability, 7(30%) complained of adverse-effects, 5(20%) said drugs were too many and 1(10%) were too busy to take the tablets.
Applying the IMB model included Information on adherence to patients understanding of adherence requirements and the adverse-effects of ART. Patients needed Motivation through social influences on adherence from partners, family members and daily reminders. Behavioural Skills were applied through by advising the HIV-infected to think about their dosing schedule on a long-term basis developing a strategy based on their activities.
Knowledge about the disease, its symptoms, treatment and adverse-effects of the medications are crucial information that has to be passed on to the patient.

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