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"It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting.

Publication ,  Journal Article
Watt, MH; Maman, S; Earp, JA; Eng, E; Setel, PW; Golin, CE; Jacobson, M
Published in: Social science & medicine (1982)
May 2009

Although HIV positive patients' adherence to antiretroviral therapy (ART) is relatively high in African nations, as compared with industrialized nations, few studies have explored why. In the research presented here we aimed to understand the dynamics of good adherence to ART among patients receiving free ART and HIV-related services from a clinic in Arusha, Tanzania. We conducted individual semi-structured interviews with 6 health care providers and 36 patients at a health care center in Arusha in 2006. Interviews were conducted in Swahili using interview guides informed by social cognitive theory. All interviews were audio-recorded, transcribed in Kiswahili, translated into English and coded for themes and patterns with ATLAS.ti. Of the 36 patients interviewed (mean time on ART 9.8 months; range 1-23 months), 32 reported perfect adherence in the previous month. Self-reported adherence was high despite economic hardship, depression, low rates of HIV disclosure and high perceived HIV-associated stigma. Five factors emerged to explain excellent adherence in the face of such barriers. First, all respondents experienced substantial improvements in their health after starting ART; this supported their confidence in the medication and motivated them to adhere. Second, their perceived need to be able to meet their family responsibilities motivated respondents to stay healthy. Third, respondents developed specific strategies to remember to take pills, particularly routinizing pill-taking by linking it with daily activities or events. Fourth, material and emotional support received from others facilitated adherence. Finally, respondents trusted the advice and instructions of their health care providers, who regularly emphasized adherence. The facilitating factors identified were consistent with the constructs of social cognitive theory and highlighted the importance of interventions that address multiple levels of influence on adherence.

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Published In

Social science & medicine (1982)

DOI

EISSN

1873-5347

ISSN

0277-9536

Publication Date

May 2009

Volume

68

Issue

10

Start / End Page

1793 / 1800

Related Subject Headings

  • Young Adult
  • Tanzania
  • Socioeconomic Factors
  • Social Support
  • Public Health
  • Professional-Patient Relations
  • Middle Aged
  • Medication Adherence
  • Male
  • Humans
 

Citation

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ICMJE
MLA
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Watt, M. H., Maman, S., Earp, J. A., Eng, E., Setel, P. W., Golin, C. E., & Jacobson, M. (2009). "It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting. Social Science & Medicine (1982), 68(10), 1793–1800. https://doi.org/10.1016/j.socscimed.2009.02.037
Watt, Melissa H., Suzanne Maman, Jo Anne Earp, Eugenia Eng, Philip W. Setel, Carol E. Golin, and Mark Jacobson. “"It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting.Social Science & Medicine (1982) 68, no. 10 (May 2009): 1793–1800. https://doi.org/10.1016/j.socscimed.2009.02.037.
Watt MH, Maman S, Earp JA, Eng E, Setel PW, Golin CE, et al. "It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting. Social science & medicine (1982). 2009 May;68(10):1793–800.
Watt, Melissa H., et al. “"It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting.Social Science & Medicine (1982), vol. 68, no. 10, May 2009, pp. 1793–800. Epmc, doi:10.1016/j.socscimed.2009.02.037.
Watt MH, Maman S, Earp JA, Eng E, Setel PW, Golin CE, Jacobson M. "It's all the time in my mind": facilitators of adherence to antiretroviral therapy in a Tanzanian setting. Social science & medicine (1982). 2009 May;68(10):1793–1800.
Journal cover image

Published In

Social science & medicine (1982)

DOI

EISSN

1873-5347

ISSN

0277-9536

Publication Date

May 2009

Volume

68

Issue

10

Start / End Page

1793 / 1800

Related Subject Headings

  • Young Adult
  • Tanzania
  • Socioeconomic Factors
  • Social Support
  • Public Health
  • Professional-Patient Relations
  • Middle Aged
  • Medication Adherence
  • Male
  • Humans