Exploring the Factors and Effects of Non-Adherence to Antiretroviral Treatment by People Living with HIV/AIDS

Abstract

The aim of the study was to determine how the health of people living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is affected by social and structural factors conducive to non-adherence to antiretroviral treatment. In a qualitative study conducted at Victoria Hospital in Alice, a town in the Eastern Cape, South Africa, 23 isiXhosa-speaking participants (including both men and women) between the ages of 18 and 60 years were interviewed. Guided by the social-ecological framework of Bronfenbrenner (1979), which is based on the notion that the health-seeking behaviour of people living with HIV/AIDS (PLWHA) is influenced by their social, institutional and physical environments, the analysis of the data identified the following themes conducive to non-adherence to antiretroviral treatment: food insecurity, financial constraints, poor service from health workers, unfair dismissal, fear of the consequences of disclosure, and rejection by church members. Based on these findings, and given that there is no single model of best practice that can appropriately address the various social and structural factors complicating the treatment of HIV/AIDS and hence the containing of the pandemic, the study suggests the need for not only supportive community initiatives, but a collaborative approach at both local and national level, and particularly in impoverished communities, by the appropriate departments of state to promote adherence to anti-retroviral treatment by making treatment and counselling facilities more accessible to PLWHA and educating communities about the implications and prevention of the disease.

Additional information

Notes on contributors

Jabulani G. Kheswa

Dr Jabulani Kheswa is a Senior Lecturer and Head of the Department of Psychology at the University of Fort Hare, Eastern Cape, South Africa.

His research interests include health psychology, psychopathology, social psychology and personality theories, and he has co-authored 25 peer reviewed journal articles and presented papers at local and international conferences in these areas.

As an adjunct to his academic work, Dr Kheswa offers workshops on psychological well-being and sexual behaviour to adolescents in secondary schools.