TY - JOUR
T1 - Patient-reported barriers and facilitators to antiretroviral adherence in Sub-Saharan Africa
T2 - a systematic review
AU - Croome, Natasha
AU - Ahluwalia, Monisha
AU - Hughes, Lyndsay D.
AU - Abas, Melanie
PY - 2017
Y1 - 2017
N2 - OBJECTIVE:: To identify the range and frequency of patient-reported barriers and facilitators to antiretroviral treatment (ART) adherence in Sub-Saharan Africa (SSA). DESIGN:: Studies from 2005-2016 were identified by searching 10 electronic databases and through additional hand and web-searching. METHODS:: Inclusion criteria were: HIV positive adults taking ART based in any SSA country, qualitative study or quantitative survey and included at least one patient-reported barrier or facilitator to ART adherence. Exclusion criteria were: only including data from treatment-naïve patients initiating ART, only single dose treatment, participants residing outside of SSA and reviews. RESULTS:: After screening 11283 records, 154 studies (163 papers) were included in this review. Forty-three barriers and 30 facilitators were reported across 24 SSA countries. The most frequently identified barriers across studies were forgetting (n?=?76), lack of access to adequate food (n?=?72), stigma and discrimination (n?=?68), side effects (n?=?67) and being outside the house or travelling (n?=?60). The most frequently identified facilitators across studies were social support (n?=?60), reminders (n?=?55), feeling better or heathier after taking ART (n?=?35), disclosing their HIV status (n?=?26) and having a good relationship with a health provider (n?=?22). CONCLUSIONS:: This review addresses the gap in knowledge by collating all the patient-reported barriers and facilitators to ART adherence in SSA. Current barriers measures need to be adapted or new tools developed to include the wide variety of factors identified. The factors that have the greatest impact need to be isolated so interventions are developed which reduce the barriers and enhance the facilitators.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
AB - OBJECTIVE:: To identify the range and frequency of patient-reported barriers and facilitators to antiretroviral treatment (ART) adherence in Sub-Saharan Africa (SSA). DESIGN:: Studies from 2005-2016 were identified by searching 10 electronic databases and through additional hand and web-searching. METHODS:: Inclusion criteria were: HIV positive adults taking ART based in any SSA country, qualitative study or quantitative survey and included at least one patient-reported barrier or facilitator to ART adherence. Exclusion criteria were: only including data from treatment-naïve patients initiating ART, only single dose treatment, participants residing outside of SSA and reviews. RESULTS:: After screening 11283 records, 154 studies (163 papers) were included in this review. Forty-three barriers and 30 facilitators were reported across 24 SSA countries. The most frequently identified barriers across studies were forgetting (n?=?76), lack of access to adequate food (n?=?72), stigma and discrimination (n?=?68), side effects (n?=?67) and being outside the house or travelling (n?=?60). The most frequently identified facilitators across studies were social support (n?=?60), reminders (n?=?55), feeling better or heathier after taking ART (n?=?35), disclosing their HIV status (n?=?26) and having a good relationship with a health provider (n?=?22). CONCLUSIONS:: This review addresses the gap in knowledge by collating all the patient-reported barriers and facilitators to ART adherence in SSA. Current barriers measures need to be adapted or new tools developed to include the wide variety of factors identified. The factors that have the greatest impact need to be isolated so interventions are developed which reduce the barriers and enhance the facilitators.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
UR - http://www.scopus.com/inward/record.url?scp=85010876715&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000001416
DO - 10.1097/QAD.0000000000001416
M3 - Article
AN - SCOPUS:85010876715
SN - 0269-9370
VL - 31
SP - 995
EP - 1007
JO - Aids
JF - Aids
IS - 7
ER -
