Botswana 2009 Botswana 2009  
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Abstract #17  -  The psychosocial determiners of compliance of people living with HIV/AIDS from rural areas to antiretroviral treatments
  Authors:
  Presenting Author:   Mr SOUBEIGA Daogo Jacques Abraham - Association "Espoir et Vie"
 
  Additional Authors:  Dr Ouedraogo Patrice Elysee,  
  Aim:
The main target of this study is to assess the level of adherence and compliance to antiretroviral treatments of people living with HIV/AIDS in rural areas regarding the psychological and social implication. The hypothesis was that there are social and psychological factors which influenced the behaviour of those ones in the follow-up of their treatments.
 
  Method / Issue:
The study took place during one year (12 months) and concerned 100 patients enrolled in ART and followed-up in our community medical center. We used to set some quantitative and qualitative variables to help assessing the hypothesis. Those variables were: the use of traditional medicines, the geographical accessibility to health center, the social perception of the disease and the ART, the daily activities. The process was to discuss with the patients selected for participating in the study through regular interviews so that we could measure the evolution of their compliance to the treatments. We also involved traditional healers in the strategy in order to apprehend and understand their role as influencing the choice of those people to using phyto-therapy and mystical curing ways and means. Finally we provided information sustained by medical workers through home visits. Those visits permitted to enter the social environment of the participants to the study and allowed us to better communicate and catch the different determiners of their life with the disease regarding their social networks and the cultural aspects.
 
  Results / Comments:
The analysis of the collected data showed remarkable results considering the variables used: - The use of traditional medicines: 100% of the participants usually take plants for curing. They take plants as complements of the treatment. 80% of them used esoteric practices encouraged by traditional healers. 65% of them try to substitute their ART when they seem feeling better. - The geographical accessibility to health center: 70% of the patients live at 35 KM to 200KM from the center. Their limited resources and means constitute reasons of non-compliance to the treatment. Indeed the cost they must pay for travel to the health center is not often available, so they do not respect the appointments that they make with the doctors for their follow-up - The social perception of the disease and the ART: there are still a lot of prejudices among the rural population regarding the HIV/AIDS. 85% of the participants have no exact and true information about the disease and its treatments. They think that the ART can completely heal them, then when they learn that it’s not so they abandon their treatments. - The daily activities: 95% of the participants are farmers or breeders. So those activities don’t let them follow-up the treatments as they have to.
 
  Discussion:
The study permitted to understand that psychosocial factors such as the use of traditional medicines, the perception of the disease and ART that is sometimes influenced by traditional leaders, localization, professional activities are important determiners of the adherence and compliance to treatment of patients from rural areas.
 
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