Format

Send to

Choose Destination
Patient Prefer Adherence. 2014 Mar 31;8:401-13. doi: 10.2147/PPA.S55547. eCollection 2014.

Alcohol use, antiretroviral therapy adherence, and preferences regarding an alcohol-focused adherence intervention in patients with human immunodeficiency virus.

Author information

1
Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa.
2
Alcohol and Drug Abuse Research Unit, Medical Research Council, Pretoria, South Africa ; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

BACKGROUND:

The primary objectives of this study were to determine the association between alcohol and antiretroviral therapy (ART) adherence and the perceived appropriateness and acceptability of elements of an adherence counseling program with a focus on alcohol-related ART nonadherence among a sample of ART recipients in human immunodeficiency virus (HIV) clinics in Tshwane, South Africa.

METHODS:

We conducted a cross-sectional study with purposive sampling. The sample comprised 304 male and female ART recipients at two President's Emergency Plan For AIDS Relief-supported HIV clinics. Using an interview schedule, we assessed patients' alcohol use (Alcohol Use Disorders Identification Test), other drug use, level of adherence to ART, and reasons for missing ART doses (AIDS Clinical Trials Group adherence instrument). Additionally, patients' views were solicited on: the likely effectiveness of potential facilitators; the preferred quantity, duration, format, and setting of the sessions; the usefulness of having family members/friends attend sessions along with the patient; and potential skill sets to be imparted.

RESULTS:

About half of the male drinkers' and three quarters of the female drinkers' Alcohol Use Disorders Identification Test scores were suggestive of hazardous or harmful drinking. Average self-reported ART adherence was 89.7%. There was a significant association between level of alcohol use and degree of ART adherence. Overall, participants perceived two clinic-based sessions, each of one hour's duration, in a group format, and facilitated by a peer or adherence counselor, as most appropriate and acceptable. Participants also had a favorable attitude towards family and friends accompanying them to the sessions. They also favored an alcohol-focused adherence counseling program that employs motivational interviewing and cognitive behavioral therapy-type approaches.

CONCLUSION:

The association between alcohol use and ART nonadherence points to a need for alcohol-focused ART adherence interventions. Patients' perceptions suggest their amenability to clinic-based brief motivational interviewing and cognitive behavioral therapy-type adherence interventions delivered by lay persons in group settings. Further research should investigate how best to implement such interventions in the existing health system.

KEYWORDS:

South Africa; adherence; alcohol; antiretroviral therapy; patient perception

Supplemental Content

Full text links

Icon for Dove Medical Press Icon for PubMed Central
Loading ...
Support Center