Marseille 2007
| Abstract #259 - Understandings and Use of Antiretroviral Therapy in Cambodia | ||||
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Session: 26.89: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Mr Pisith Phlong - NCHADS, Cambodia |
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| Additional Authors: Mr Pisith Phlong, Mr Julian Elliott, Mr Huort Teng, Mr Saramony Sarun, Dr Vothanak Saphonn, Dr John Kaldor, Dr Lisa Maher, | ||||
| Aim: Use of antiretroviral therapy (ART) in Cambodia occurs within a context of diverse beliefs and experiences of both traditional and modern therapies. Understanding HIV treatment beliefs and practices of people living with HIV is crucial to the design of effective strategies to promote ART adherence. | ||||
| Method / Issue: We investigated beliefs and practices regarding treatment of HIV, including traditional and antiretroviral therapies and antiretroviral adherence, in Cambodia. Qualitative in-depth interviews were conducted with 26 people living with HIV and three health care workers. Participants were recruited from HIV clinics, home based care networks and peer support groups in Phnom Penh and two rural provinces using a maximum variation theoretical sampling strategy. Tape-recorded interviews were transcribed in Khmer and translated into English. Data were analysed in both Khmer and English using an inductive approach. | ||||
| Results / Comments: Participants described evolving beliefs and practices regarding treatment of HIV. Personal and observed experiences with various treatments and communicated messages from social networks, media and health care workers shape individual treatment behavior including adherence practices. Use of ART is highly ritualized and prioritized over daily routines. ART adherence is promoted by restricted access to ART, complex preparation for treatment, frequent follow up visits and personalised reminder strategies. Occasional late and missed doses are reported. Adherence may be encouraged by the stigma attached to the use of refrigerated second line antiretroviral drugs, which is viewed as the last stage of HIV treatment and a sign of hopelessness. ART use is conducted during ongoing experiences of stigma, poverty and unwellness. | ||||
| Discussion: Adherence to ART in Cambodia is a complex practice arising from varied traditional and modern HIV treatment beliefs and practices Strategies designed to foster ART adherence which take account of these realities will be important in determining the long term success of HIV treatment programs in resource-limited settings such as Cambodia. | ||||
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