Model of socio-cultural dimensions involved in adherence to antiretroviral therapy for HIV/AIDS in public health care centers in Chile

ABSTRACT

In Chile, over 14,000 adults are living with HIV receive antiretroviral therapy (HAART). Adequate adherence to HAART has a major impact on survival. There is little consensus on the causes of poor adherence, due to the unique and diverse sociocultural parameters involved in the issue. The objective of this study was to identify sociocultural dimensions that serve as barriers or facilitators to HAART adherence among persons living with HIV/AIDS (PLHIV) in Chile. A qualitative study design, with an exploratory followed by a descriptive phase was conducted. The study population consisted of adults living with HIV/AIDS, with and without HAART. A theoretical sample was designed and three gender profiles defined: women, men, and transwomen. Data collection methods included in-depth interviews by anthropologists in seven public health care centers for PLHIV. The model of sociocultural dimensions indicated that factors associated with family, expectations, gender/sexuality, affect, relationship with HIV, HAART, work, social support and networks, and stigma and discrimination influenced adherence, with different patterns among profiles. This study found that adherence is a dynamic category. It is crucial to consider sociocultural factors in developing strategies to improve HAART adherence.

KEYWORDS:

• HIV
• adherence
• sociocultural issues
• gender
• gender identity

Acknowledgements

We thank Drs Beatriz Marincovich, Marcelo Wolff, Carlos Gallo, Elizabeth Barthel, Martin Lasso, Esteban Cortez, Carolina Chahín, and Rossana Benítez, for the interest in participating in this project with local teams care centers for people living with HIV. Finally, we thank all the interviewees, who unselfishly wanted to contribute to progress in the fight against HIV, with their life stories and confidence.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Fondo Nacional de Investigación y Desarrollo en Salud (FONIS-Chile) [grant number SA12I2037].