Barriers to adherence to antiretroviral medications among patients living with HIV in southern China: a qualitative study

Although China's government is rapidly expanding access to antiretroviral therapy, little is known about barriers to adherence among Chinese HIV-infected patients, particularly among injection drug users. To better understand barriers to antiretroviral treatment adherence, we conducted a qualit...

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Bibliographic Details
Published in:	AIDS care Vol. 20; no. 10; pp. 1242 - 1250
Main Authors:	Sabin, Lora L., Desilva, Mary Bachman, Hamer, Davidson H., Keyi, Xu, Yue, Yuan, Wen, Fan, Tao, Li, Heggenhougen, Harald K., Seton, Lewis, Wilson, Ira B., Gill, Christopher J.
Format:	Journal Article
Language:	English
Published:	Abingdon Taylor & Francis Group 01-11-2008 Taylor & Francis Taylor & Francis Ltd
Subjects:	Adherence Adult AIDS Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral therapy Biological and medical sciences China China (People's Republic) Drug use Drugs Female Focus Groups Gender differences Heroin HIV HIV Infections - drug therapy HIV Infections - economics HIV Infections - psychology Human immunodeficiency virus Human viral diseases Humans Infectious diseases injection drug users Intravenous drug addicts Male Medical sciences Medical treatment Medication Adherence - psychology Medicine Mental health Mental health services Middle Aged Patients Prejudice Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Qualitative analysis Qualitative research Risk Factors Social norms Social psychiatry. Ethnopsychiatry Social values Sociocultural environment Stigma Stigmatization Studies Substance-Related Disorders - psychology Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids vocational support Women Young Adult Asia China Social environment Occupational adjustment Antiretroviral agent Intravenous administration Stigma Mental health Sex Drug compliance Health policy Antiviral Qualitative analysis Public health Consumption Human Immunopathology Illicit drug Retroviridae AIDS Immune deficiency Lentivirus Recommendation Infection Virus Sociodemographic factor Viral disease Human immunodeficiency virus
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Summary:	Although China's government is rapidly expanding access to antiretroviral therapy, little is known about barriers to adherence among Chinese HIV-infected patients, particularly among injection drug users. To better understand barriers to antiretroviral treatment adherence, we conducted a qualitative research study, using both focus group and key informant methods, among 36 HIV-positive men and women in Dali, in southwestern China. All interviews utilized semi-structured question guides and were conducted in Mandarin, audio-recorded and translated into English for analysis. The most commonly cited adherence challenges were stigma, including secondary stigma experienced by family members; mental health issues; and economic concerns, particularly related to finding and maintaining employment. Distinctive gender differences emerged, partly due to previous heroin use among male respondents. Optimizing adherence may require that antiretroviral therapy programs be linked to other services, including drug addiction treatment, mental health services and vocational treatment and support. HIV care and service providers and policy makers in China responsible for HIV treatment should be aware of these important barriers to adherence.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0954-0121 1360-0451
DOI:	10.1080/09540120801918651