Barriers to adherence in patients failing second-line antiretroviral treatment in a township in South Africa: a qualitative research study

The recent scale-up of ART coverage in resource-limited settings has greatly improved access to treatment. However, literature indicates that patients on ART have high rates of non-adherence (32% to 67%), virological failure (5.2%, to 47%) and resistance to ARVs (5.4% to 80%). These patients are failing first- and second-line ART, leaving no treatment options for successful virus suppression. Yet, literature addressing facilitators and barriers faced by patients on secondline ART is scarce. This study examined factors affecting adherence to second-line ART from the perspective of clinic staff as well as second-line failure patients, assessing both individual and structural barriers. Research was conducted at a large primary-care clinic in Khayelitsha, a periurban township in Cape Town, South Africa. A literature review was conducted to present 1) rates of non-adherence, virological failure and resistance and 2) to present known facilitators & barriers faced by patients on ART, with a specific focus on second-line patients. The literature was found via PubMed and Cochrane Central Register of Controlled Trials (CENTRAL), with a preference for studies in low and middle income countries and those including second-line ART populations. The primary research used participants who were drawn from an MSF-run program to support patients failing second-line treatment.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2012

Author dc:creator

• Barnett, Whitney

Advisor dc:contributor.advisor

• Colvin, Christopher J

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/10134

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/10134