Marseille 2007
| Abstract #169 - Study design and baseline results of a longitudinal qualitative substudy of ART adherence nested in a randomised controlled trial comparing home- and facility-based delivery in Jinja, Uganda | ||||
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Session: 26.76: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Brent Wolff - MRC/UVRI Uganda Research Unit on AIDS, Uganda |
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| Additional Authors: Mr Martin Mbonye, Ms Sarah Nakamanya, Dr Barbara Amuron, Dr Shabbar Jaffar, | ||||
| Aim: Assessing adherence to antiretroviral therapy (ART) and its causes requires a combination of qualitative and quantitative methodologies. We present the design of a longitudinal substudy of adherence nested within a randomised controlled trial comparing home- and facility-based delivery of ART in Uganda and baseline results. | ||||
| Method / Issue: 41 of 1000 main trial participants were recruited between October 2005 and March 2006 in order of enrolment to achieve equal distributions by trial arm, sex, and relative disease progression based on CD4 count and WHO stage (<100 CD4 and stage 4 vs. >150 or stage 1 or 2). Each consented to give in-depth interviews at enrolment, 3, 6, 18, and 36 months together with home observation visits after 3 months on ART. Analysis of in-depth enrolment interviews regarding expectations about ART are presented with data on knowledge and attitudes towards ART from structured enrolment questionnaires. | ||||
| Results / Comments: All clients had experienced imminent fear of death and social withdrawal through widowhood, unemployment, or stigmatisation prior to study enrolment. Feelings of vulnerability and dependence were common. Personal acceptance of HIV status was high and disclosure to others was common. Expectations and motivation to adhere to ART were very high, and side effects were anticipated to be limited to one or two months. Women emphasized renewed hope of seeing their children mature, men of returning to work. Few thought about return to sexual activity or childbearing. Main concerns involved ability to pay for food and transport, and long-term availability of drugs. | ||||
| Discussion: Fear of death and dependence from long illness created strong motivation to adherence. Participants anticipate poverty as the greatest barrier to adherence prior to starting ART. | ||||
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