ABSTRACT
Anti-retroviral drugs (ARVs) are supplied free of charge in Botswana. Lifelong adherence to anti-retroviral therapy (ART) is vital to improve the patient's state of well-being and to prevent the development of strains of the human immunodef ciency virus (HIV) that are resistant to ART. Persons with ART-resistant strains of HIV can spread these to other people; requiring more expensive ART with more severe side-effects and poorer health outcomes. The purpose of this exploratory; descriptive; qualitative study was to determine nurses' perspectives on Botswana patients' anti-retroviral therapy (ART) adherence; and to identify factors which could promote or hinder ART adherence. Four ART sites were randomly selected and all 16 nurses providing ART services at these sites participated in semi-structured interviews. These nurses indicated that patients' ART adherence was inf uenced by service-related and patient-related factors. Service-related factors included the inaccessibility of ART clinics; limited clinic hours; health workers' inability to communicate in patients' local languages; long waiting times at clinics and delays in being informed about their CD4 and viral load results. Nurses could not trace defaulters nor contact them by phone; and also had to work night shifts; disrupting nurse-patient relationships. Patient-related factors included patients' lack of education; inability to understand the significance of CD4 and viral load results; financial hardships; non-disclosure and non-acceptance of their HIV positive status; alcohol abuse; the utilisation of traditional medicines and side effects of ART. The challenges of lifelong ART adherence are multifaceted involving both patient-related and service-related factors. Supplying free ARVs does not ensure high levels of ART adherence
Subject(s)
Medication Adherence , Nurses , PerceptionABSTRACT
This study aimed to explore and describe the health beliefs and practices of urban Pares, living in Moshi, Tanzania. No previously documented studies of the health beliefs of the Pare were identified. This transcultural qualitative study utilised semistructured interviews conducted with nine informants, followed by thematic analysis of the interview data. Unlike professional health care workers functioning within the scientific paradigm, urban Pare health beliefs arise from magico-religious, holistic and scientific paradigms. Beliefs and behaviour patterns are however changing. Nurses caring for urban Pares can use the findings and recommendations from this study to enhance culturally congruent care.
