Adherence to Antiretroviral Therapy among Older HIV-infected Persons Receiving Treatment in a Public Hospital in Gauteng Province

Abstract

Adherence to antiretroviral therapy (ART) is a complex and dynamic process and remains an important issue in HIV care. Literature has highlighted sub-optimal adherence to ART across settings and populations, with many factors influencing the level of adherence. While older adults have been characterised as being more compliant, other studies have demonstrated at least 50% poor adherence. The aim of this study was to explore and describe own perspectives on adherence to ART among older persons receiving HIV treatment in a public hospital in Gauteng Province, South Africa. This study used a qualitative exploratory design that included a purposive sample of older HIV-infected men and women currently receiving HIV healthcare services from a public hospital in Gauteng Province. Individual interviews with 12 purposively selected older participants were conducted. The data were analysed using a thematic approach. Findings of the study revealed five main themes, namely: 1) disclosure, stigma and adherence; 2) drug-related side effects; 3) difficulties related to social factors and lifestyle; 4) support and adherence to ART; as well as 5) experience with the health system. Recommendations include empowering older persons in managing internalised stigma, monitoring of adherence by healthcare providers, and educating family and other support structures to form part of adherence enhancing strategies.