The Value of Support Group Participation in Influencing Adherence to Antiretroviral Treatment among People Living with Human Immunodeficiency Virus (HIV)

Simpson Tumwikirize^1*, Kwasi Torpey², Oluwasanmi Adedokun², Tilitope Badru²

¹Program for Appropriate Technologies in Health, Kampala, Uganda.
²Family Health International, Abuja, Nigeria.

DOI: 10.4236/wja.2015.53022                

Abstract

Advances in antiretroviral therapy for both Human Immunodeficiency Virus (HIV) treatment and prevention have increased interest in adherence to HIV treatment. This is because the individual patient and public health benefits of antiretroviral treatment (ART) greatly depend on the extent to which people living with HIV (PLHIV) adhere to the prescribed daily dosing regimens. Studies have shown that nonadherence to ART increases drug resistance, morbidity and person-to-person HIV transmission. Public health experts are trying different innovations to enhance ART adherence, including promoting support groups of PLHIV. The purpose of this study was to determine the value of support group participation in enhancing ART adherence. The study used a cross-sectional design to compare ART adherence among PLHIV who participate in support group activities and those who do not. Respondents were adults who were initiated on ART between January 1, 2010 and December 31, 2012. Multistage probability sampling was used to select study sites and respondents. Data was collected using a self-administered questionnaire from 1676 respondents between February and May 2014. Data was analyzed using STATA. Univariate analysis was carried out to generate descriptive statistics, while Chi-square tests were used to examine if there was an association between participation in support group activities and antiretroviral treatment adherence. ART adherence was self-reported by 745/788 (95%) and 814/888 (92%) respondents who had ever and had never participated in support group activities respectively. Among respondents who reported nonadherence to ART, 74/117 (8%) had never participated in support group activities compared to just 43/117 (5%) who participated in support group activities. These findings suggest that PLHIV who participate in support group activities are more likely to adhere to ART than those who do not participate. This implies that there is value in participating in support groups by PLHIV in terms of ART adherence.

Keywords

Support Groups, Human Immunodeficiency Virus, Participation, Antiretroviral Therapy, Adherence

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	United Nations Program on HIV/AIDS (UNAIDS) (2013) Report of the Global AIDS Epidemic 2012. http://www.unaids.org/en/media/unaids/contentassets/documents/epidemiology/2012/gr2012/2012 1120_UNAIDS_Global_Report_2012_with_annexes_en.pdf
[2]	World Health Organization (WHO) (2013) Adherence to Long-Term Therapies-Evidence for Action. http://apps.who.int/medicinedocs/en/d/Js4883e/8.9.1.html
[3]	Enriquez, M. and McKinsey, D.S. (2011) Strategies to Improve HIV Treatment Adherence in Developed Countries: Clinical Management at the Individual Level. Dove Press Journal. HIV/AIDS—Research and Palliative Care, 3, 45-51. http://dx.doi.org/10.2147/HIV.S8993
[4]	Obirikorang, C., Selleh, K.P., Abledu, J.K. and Fofie, C.O. (2013) Predictors of Adherence to Antiretroviral Therapy among HIV/AIDS Patients in the Upper West Region of Ghana. ISRN AIDS, 2013, Article ID: 873939. http://dx.doi.org/10.1155/2013/873939
[5]	Okoronkwo, I., Okeke, U., Chinweuba, A. and Iheanacho, P. (2013) Nonadherence Factors and Sociodemographic Characteristics of HIV-Infected Adults Receiving Antiretroviral Therapy in NnamdiAzikiwe University Teaching Hospital, Nnewi, Nigeria. ISRN AIDS, 2013, Article ID: 843794. http://dx.doi.org/10.1155/2013/843794
[6]	Paterson, D.L., Swindells, S., Mohr, J., Brester, M., Veris, E.N., Squier, C., et al. (2000) Adherence to Protease Inhibitor Therapy and Outcomes in Patients with HIV. Annals of Internal Medicine, 133, 21-30. http://dx.doi.org/10.7326/0003-4819-133-1-200007040-00004
[7]	Kalichman, S.C., Ntseane, D., Nthomang, K., Segwabe, M., Phorano, O. and Simbayi, L.C. (2007) Recent Multiple Sexual Partners and HIV Transmission Risks among People Living with HIV/AIDS in Botswana. Sexually Transmitted Infections, 83, 371-375. http://dx.doi.org/10.1136/sti.2006.023630
[8]	Dessie, Y. and Deresa, M. (2012) Sexual Practices of HIV-Positive Individuals Attending Antiretroviral Treatment (ART) in Addis Ababa Public Hospitals: Findings from In-Depth Interview. The Pan African Medical Journal, 13, 80.
[9]	Kidder, D.P., Bachanas, P., Medley, A., Pals, S. and Nuwagaba-Biribonwoha, H. (2013) HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviours among HIV Patients in Kenya, Namibia, and Tanzania. PLoS ONE, 8, e57215. http://dx.doi.org/10.1371/journal.pone.0057215
[10]	Ndziessi, G., Cohen, J., Kouanfack, C., Boyer, S., Moatti, J., Marcellin, F., et al., ANRS 12110/ESTHER Study Group (2013) Changes in Sexual Activity and Risk Behaviors among PLWHA Initiating ART in Rural District Hospitals in Cameroon—Data from the STRATALL ANRS 12110/ESTHER Trial. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV, 25, 347-355.
[11]	Overstreet, N.M., Earnshaw, V.A., Kalichman, S.C. and Quinn, D.M. (2013) Internalized Stigma and HIV Status Disclosure among HIV-Positive Black Men Who Have Sex with Men. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV, 25, 466-471. http://dx.doi.org/10.1080/09540121.2012.720362
[12]	Omosanya, O.E., Elegbede, O.T., Agboola, S.A., Isinkaye, A.O. and Omopariola, O.A. (2013) Effects of Stigmatization/Discrimination on Antiretroviral Therapy Adherence among HIV-Infected Patients in a Rural Tertiary Medical Centre in Nigeria. Journal of the International Association of Providers of AIDS Care, 13, 260-263.
[13]	Bolton, P., Bass, J., Neugebauer, R., Verdeli, H., Loughery, K.F., Wickramaratne, P., et al. (2003) Group Interpersonal Psychotherapy for Depression in Rural Uganda. A Randomized Controlled Trial. Journal of American Medical Association, 289, 3117-3124. http://dx.doi.org/10.1001/jama.289.23.3117
[14]	Uchino, B. (2004) Social Support and Physical Health: Understanding the Health Consequences of Relationships. Yale University Press, New Haven, 16-17. http://dx.doi.org/10.12987/yale/9780300102185.001.0001
[15]	Bekele, T., Rourke, S.B., Tucker, R., Greene, S., Sobota, M., Koornstra, J., et al. (2013) The Positive Spaces Healthy Places Team. Direct and Indirect Effects of Perceived Social Support on Health-Related Quality of Life in Persons Living with HIV/AIDS. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV, 25, 337-346.
[16]	Qiao, S., Li, X. and Stanton, B. (2013) Social Support and HIV-Related Risk Behaviours: A Systematic Review of the Global Literature. AIDS Behaviour, 18, 419-441.
[17]	Turner-Cobb, J.M., Gore-Felton, C., Marouf, F., Koopman Kim, P., Israelski, D. and Spiegel, D. (2002) Coping, Social Support, and Attachment Style as Psychosocial Correlates of Adjustment in Men and Women with HIV/AIDS. Journal of Behavioral Medicine, 25, 337-353. http://dx.doi.org/10.1023/A:1015814431481
[18]	Fanell, C.W. and Moyo, R.A. (2008) Guidelines for Establishing and Operating Successful Support Groups for People Living with HIV. Catholic Relief Services, Harare.
[19]	Gagne, G.C. and Naccache, H. (2003) Validation of a Self-Reported Questionnaire Assessing Adherence to Antiretroviral Medication. AIDS Patient Care STDs, 17, 325-332. http://dx.doi.org/10.1089/108729103322231268
[20]	Walakira, E., Kaawa-Mafigiri, D., Byamugisha, J. and Parker Rogers, S. (2012) HIV Perspectives of PLHIV on HIV Prevention: Opportunities and Challenges for Strengthening the Response in Uganda. Family Health International, Washington DC.
[21]	Madiba, S. and Canti-Sigaqa, V. (2012) Barriers to Participate in Support Groups for People Living with HIV: A Qualitative Study with Men Receiving Antiretroviral Treatment in an HIV Clinic in Mthatha, South Africa. Global Journal of Health Science, 4,119-128.
[22]	Babatunde, A., Tawab, N., Geibel, S., Kalibala, S., Okal, J., Mane, B., et al. (2014) HIV/AIDS Vulnerabilities, Discrimination, and Service Accessibility among Africa’s Youth: Insights from a Multi-Country Study. Population Council, Abuja.
[23]	Kamau, T.M., Olsen, V.G., Zipp, G.P. and Clark, M. (2012) The Effectiveness of Social Resource Intervention to Promote Adherence to HIV Medication in a Multidisciplinary Care Setting in Kenya. International Journal of STD & AIDS, 23, 843-848. http://dx.doi.org/10.1258/ijsa.2012.011472
[24]	Sarna, A., Luchters, S., Musenge, E., Okal, J., Chersich, M., Tun, W., et al. (2013) Effectiveness of a Community-Based Positive Prevention Intervention for People Living with HIV Who Are Not Receiving Antiretroviral Treatment: A Prospective Cohort Study. Global Health: Science and Practice, 1, 52-67.
[25]	Walstrom, P., Operario, D., Zlotnick, C., Mutimura, E., Benekigeri, C. and Cohen, M.H. (2013) I Think My Future Will Be Better Than My Past: Examining Support Group Influence on the Mental Health of HIV-Infected Rwandan Women. Global Public Health, 8, 90-105. http://dx.doi.org/10.1080/17441692.2012.699539