Article

HIV-related knowledge and adherence to HAART

Office of Special Populations, New York Academy of Medicine, NY 10029, USA.
AIDS Care (Impact Factor: 1.6). 11/2003; 15(5):673-9. DOI: 10.1080/09540120310001595159
Source: PubMed

ABSTRACT

Near perfect adherence is considered essential for patients on HAART, yet adherence to medical recommendations is rarely so high. Supportive services and reminder tools may help individuals to become adherent, yet it is difficult to determine who may need such interventions. In this study, based on data from the NYSDOH/AIDS Institute Treatment Adherence Demonstration Program, we look at the association between HIV-related knowledge and adherence, hypothesizing that a better understanding of HIV and its treatment is associated with better adherence. In analyses based on 997 participants, knowledge, as measured by five true/false questions, was significantly associated with self-reported adherence. In multivariate analysis, compared to persons with four or five items answered correctly, persons with fewer correct answers were more likely to report missed doses (OR = 1.72 for 2-3 correct, p < 0.01; OR = 2.92 for 0-1 correct, p < 0.05). Our data suggest that providers should include questions focused on knowledge of HIV in their assessments of medication readiness and need for adherence support. Similarly, providers should be diligent with respect to patient education, ensuring that each patient has the information needed to support reasoned decision making and adequate adherence.

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Available from: Tyler French, Jul 24, 2014
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    • "Thus health literacy, defined as the ability to read and understand medical information, may be a key factor in the disclosure of HIV status to HIV-infected children in resource-limitedsettings. Health literacy has been associated with favorable HIV treatment outcomes (Kalichman, Ramachandran, &amp; Catz, 1999;Weiss et al., 2003). Although, the instruments we used have been validated in some resource-limited countries (Kotze et al., 2013;Lipps et al., 2010), consideration should be given to validating them in the country of study prior to their use. "
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    ABSTRACT: The majority of HIV-infected children in sub-Saharan Africa have not been informed of their HIV status. Caregivers are reluctant to disclose HIV status to their children because of concern about the childs ability to understand, parental sense of guilt, and fear of social rejection and isolation. We hypothesized that the low prevalence of pediatric HIV disclosure in Ghana is due to lack of accurate HIV information and high HIV stigma among caregivers. This is a preliminary analysis of baseline data of an HIV pediatric disclosure intervention study in Ghana ("Sankofa"). "Sankofa"-is a two-arm randomized controlled clinical trial comparing disclosure intervention plus usual care (intervention arm) vs usual care (control arm) at Korle-Bu Teaching Hospital (KBTH; control arm) and Komfo-Anokye Teaching Hospital (KATH; intervention arm). We enrolled HIV-infected children, ages 7-18 years who do not know their HIV status, and their caregivers. Baseline data of caregivers included demographic characteristics; Brief HIV Knowledge Questionnaire (HIV-KQ-18); Brief Illness Perception Questionnaire; and HIV Stigma Scale. Simple and multivariable linear regression analyses were used to assess the relationship between caregiver characteristics and HIV knowledge, stigma, and illness perception. Two hundred and ninety-eight caregivers were enrolled between January 2013 and July 2014 at the two study sites; KBTH (n = 167) and KATH (n = 131). The median age of caregivers was 41 years; 80.5% of them were female and about 60% of caregivers were HIV-positive. Seventy-eight percent of caregivers were self-employed with low household income. In both unadjusted and adjusted analyses, HIV negative status and lower level of education were associated with poor scores on HIV-KQ. HIV positive status remained significant for higher level of stigma in the adjusted analyses. None of the caregivers characteristics predicted caregivers illness perception. Intensification of HIV education in schools and targeted community campaigns are needed.
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    • "Our findings also indicate that ART providers must become more aware of the importance of religion and traditional medicine in patients' decision-making regarding ART Field Code Changed Field Code Changed Field Code Changed Deleted: . Deleted: side effects Deleted: Feasible tools to assess readiness for treatment are also needed (Crane et al., 2006; Nordqvist, Sodergard, Tully, Sonnerborg, & Lindblad, 2006; Weiss et al., 2003) ¶ "
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    ABSTRACT: The aim of this study was to explore why patients in the urban Kibera slum, Nairobi, Kenya, offered free antiretroviral treatment (ART) at the Médecins Sans Frontièrs (MSF) clinic, choose not to be treated despite signs of AIDS. Qualitative semi-structured interviews were conducted with 26 patients, 9 men and 17 women. Six main reasons emerged for not accepting ART: a) fear of taking medication on an empty stomach due to lack of food; b) fear that side-effects associated with ART would make one more ill; c) fear of disclosure and its possible negative repercussions; d) concern for continuity of treatment and care; e) conflicting information from religious leaders and community, and seeking alternative care (e.g. traditional medicine); f) illiteracy making patients unable to understand the information given by health workers.
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    • "As a result, youth may need support for enhancing adherence and managing difficulties with treat- ments. Patients' understanding of their medical condition and treatment recommendations is a strong predictor of treatment adherence [32]. This study found that many HIVpositive youth were confused or skeptical about the purpose and value of HIV treatment. "
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    ABSTRACT: Half of new HIV infections worldwide occur among young people. Youth, particularly young women aged 15-29 years, represent a growing population to experience HIV. This study investigated HIV-positive youths' perceptions of, and experiences with, antiretroviral treatment. A community-based, participatory approach was used to conduct a mixed methods research study. Thirty-four qualitative, in-depth, semi-structured interviews were conducted with HIV-positive youth (ages 12-24 years) in Ontario, Canada. Brief structured demographic surveys were also administered. A research team of HIV-positive youth, professionals, and researchers collaboratively analyzed the data for emerging themes. Four major themes emerged: Treatment knowledge: confusion and skepticism. Many participants did not understand, or believe in, antiretroviral treatment. Some youth on treatment did not understand why they were taking medications. Treatment decision-making: lack of choice and feeling emotionally unprepared. Some youth did not feel that they had choices about treatment, and others did not feel ready to make treatment decisions. Difficulties taking medications. Youth had problems with social routine disruption, feeling "different" and side effects. Many viewed costs of medications as a barrier to treatment. Inconsistent treatment adherence and treatment interruptions, which were common amongst participants. Youth may need support for managing difficulties with treatments, such as side effects, social impacts, and adherence. Developmentally appropriate, empowerment-based treatment education may be helpful for HIV-positive youth. The availability of social programs to provide treatment access does not guarantee that youth will be aware of them. This may indicate a need for youth-specific outreach.
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