Volume 41, Issue 2 p. 149-157

Patients’ Adherence to Anti-Retroviral Therapy in Botswana

Esther Kip RN

Esther Kip RN

Doctoral Student, University of South Africa, Pretoria, South Africa

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Valerie J. Ehlers RN, D Litt et Phil

Valerie J. Ehlers RN, D Litt et Phil

Tau Lambda-at-large , Professor, Department of Health Studies, University of South Africa, Pretoria, South Africa

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Dirk M. Van Der Wal RN, D Litt et Phil

Dirk M. Van Der Wal RN, D Litt et Phil

Tau Lambda-at-large , Senior Lecturer, Department of Health Studies, University of South Africa, Pretoria, South Africa

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First published: 01 June 2009
Citations: 36
Correspondence
Prof. Ehlers, PO Box 65075, Erasmusrand (Pretoria), 0165. South Africa. E-mail: [email protected]

Abstract

Purpose: To identify factors influencing patients’ anti-retroviral therapy (ART) adherence at four clinics in Botswana.

Design: Quantitative descriptive. Structured interviews were conducted with a random sample of 400 patients out of the population of all patients attending the four randomly selected ART clinics in Botswana during April and May 2007.

Methods: Data were analysed using SPSS version 13. Chi-square and p-value calculations were done to test significance of the relationships between categories or variables.

Findings: Patient-centred barriers to ART adherence included inadequate knowledge about ART, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), CD4 cell and viral-load results, stigma, travelling costs, waiting times at clinics, side effects of ART, use of traditional (indigenous or folk) medicines, and abuse of alcohol. Service-centred barriers included nurses’ attitudes and knowledge, health workers’ inability to conduct home visits and to contact defaulters, limited clinic hours, delays in getting CD4 and viral-load results.

Conclusions: ART adherence requires more than free ART. Adherence levels will improve if both patient-centred and service-centred barriers are addressed.

Clinical Relevance: Nurses play key roles in educating patients about ART adherence and side effects, but they should also educate patients about CD4 and viral-load test results and about the dangers of using traditional medicines and alcohol with ART. Shorter waiting times at clinics could make ART patients’ lives more manageable.