Marseille 2007
| Abstract #433 - Antiretroviral therapy among high risk women in Burkina Faso: adherence issues and parallel therapeutic resources. | ||||
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Session: 24.3: Adherence (Parallel) on Monday @ 16.30-18.30 in HC Chaired by Ana Josefina Guell, Rahul Battcharya Authors: Presenting Author: Ms Ramata DIALLO - Centre Muraz, Burkina Faso |
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| Additional Authors: Mr Anselme SANON, Mr Abdoulaye OUEDRAOGO, Mr Issouf KONATE, Mr Isidore TRAORE, Ms Charlotte HUET, | ||||
| Aim: Recent national and international initiatives have facilitated the access to antiretroviral treatments (ART) in Africa. Such long-term therapy may turn difficult to implement in hard-to-reach and marginalized populations who are only used to short-term treatments prescribed for acute infections. The role of parallel therapeutic resources (traditional medicine, therapeutic prayer, etc.) can complicate the relationships with modern medicine. The aim of this work is to understand the effect of psychological and cultural determinants on parallel resources behaviours, and to study the relationship between the latter and ART therapy. | ||||
| Method / Issue: This qualitative study enrolled HIV-infected women, treated or not with ART, from a cohort of high-risk women in Bobo-Dioulasso, Burkina Faso. A face-to-face questionnaire was administered about their perception of HIV disease, the psychological problems they meet, the type of parallel therapeutic resources they used and their level of ART adherence for the ones. Low adherence was defined as not taking ART one time or more in a month. | ||||
| Results / Comments: A total of 41 women were enrolled, including 16 taking ART. Overall, 27 reported 36 parallel resources (traditional medication = 4 ; Herbalist = 9 ; Soothsayer = 4; Modern Herbalist = 3 ; Charismatic Prayer = 15 ; Urine therapeutic = 1). The use of parallel therapeutic resources was determined by HIV disease perception: the more the patient thought her disease was in relation with witchcraft, fate or possession, the more she turned to parallel therapeutic resources. Among women taking ART, adherence seemed altered by parallel therapies (6/9 women with low adherence used parallel therapeutic resources, vs. 3/9 of women with good adherence, and by psychological problems (on the average 9,5 / 17 [4-17] psychological problems were observed among women who met adherence issues, vs 8,5 [1-15] for women who had good adherence). | ||||
| Discussion: The decision to use (and the choice) parallel therapeutic resources is mainly influenced by the way women perceive their HIV disease. Both parallel therapeutic resources and psychological problems have a negative effect on adherence to ART, stressing the need to provide psychological support to HIV-infected individuals in Africa. It may help them modulate their disease perception and thereby their adherence to ART. | ||||
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