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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa</title>
<author><name sortKey="Van Loggerenberg, Francois" sort="Van Loggerenberg, Francois" uniqKey="Van Loggerenberg F" first="Francois" last="Van Loggerenberg">Francois Van Loggerenberg</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2"></nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gray, Debra" sort="Gray, Debra" uniqKey="Gray D" first="Debra" last="Gray">Debra Gray</name>
<affiliation><nlm:aff id="aff3"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gengiah, Santhanalakshmi" sort="Gengiah, Santhanalakshmi" uniqKey="Gengiah S" first="Santhanalakshmi" last="Gengiah">Santhanalakshmi Gengiah</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kunene, Pinky" sort="Kunene, Pinky" uniqKey="Kunene P" first="Pinky" last="Kunene">Pinky Kunene</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gengiah, Tanuja N" sort="Gengiah, Tanuja N" uniqKey="Gengiah T" first="Tanuja N." last="Gengiah">Tanuja N. Gengiah</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Naidoo, Kogieleum" sort="Naidoo, Kogieleum" uniqKey="Naidoo K" first="Kogieleum" last="Naidoo">Kogieleum Naidoo</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grant, Alison D" sort="Grant, Alison D" uniqKey="Grant A" first="Alison D." last="Grant">Alison D. Grant</name>
<affiliation><nlm:aff id="aff2"></nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25692575</idno>
<idno type="pmc">4410570</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410570</idno>
<idno type="RBID">PMC:4410570</idno>
<idno type="doi">10.1089/apc.2014.0293</idno>
<date when="2015">2015</date>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa</title>
<author><name sortKey="Van Loggerenberg, Francois" sort="Van Loggerenberg, Francois" uniqKey="Van Loggerenberg F" first="Francois" last="Van Loggerenberg">Francois Van Loggerenberg</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff2"></nlm:aff>
</affiliation>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gray, Debra" sort="Gray, Debra" uniqKey="Gray D" first="Debra" last="Gray">Debra Gray</name>
<affiliation><nlm:aff id="aff3"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gengiah, Santhanalakshmi" sort="Gengiah, Santhanalakshmi" uniqKey="Gengiah S" first="Santhanalakshmi" last="Gengiah">Santhanalakshmi Gengiah</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kunene, Pinky" sort="Kunene, Pinky" uniqKey="Kunene P" first="Pinky" last="Kunene">Pinky Kunene</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gengiah, Tanuja N" sort="Gengiah, Tanuja N" uniqKey="Gengiah T" first="Tanuja N." last="Gengiah">Tanuja N. Gengiah</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Naidoo, Kogieleum" sort="Naidoo, Kogieleum" uniqKey="Naidoo K" first="Kogieleum" last="Naidoo">Kogieleum Naidoo</name>
<affiliation><nlm:aff id="aff4"></nlm:aff>
</affiliation>
</author>
<author><name sortKey="Grant, Alison D" sort="Grant, Alison D" uniqKey="Grant A" first="Alison D." last="Grant">Alison D. Grant</name>
<affiliation><nlm:aff id="aff2"></nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">AIDS Patient Care and STDs</title>
<idno type="ISSN">1087-2914</idno>
<idno type="eISSN">1557-7449</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p>Taken as prescribed, that is, with high adherence, combination antiretroviral therapy (ART) has changed HIV infection and disease from being a sure predictor of death to a manageable chronic illness. Adherence, however, is difficult to achieve and maintain. The CAPRISA 058 study was conducted between 2007 and 2009 to test the efficacy of individualized motivational counselling to enhance ART adherence in South Africa. As part of the overall trial, a qualitative sub-study was conducted, including 30 individual interviews and four focus group discussions with patients in the first 9 months of ART initiation. Data were inductively analyzed, using thematic analysis, to identify themes central to ART adherence in this context. Four themes emerged that characterize the participants' experiences and high motivation to adhere to ART. Participants in this study were highly motivated to adhere, as they acknowledged that ART was ‘life-giving’, in the face of a large amount of morbidity and mortality. They were further supported by techniques of routine remembering, and highlighted the importance of good social support and access to supportive healthcare workers, to their continued success in negotiating their treatment. Participants in the current study told us that their adherence motivation is enhanced by free accessible care, approachable and supportive healthcare workers, broad social acceptance of ART, and past first-hand experiences with AIDS-related co-morbidity and mortality. Programs that include specific attention to these aspects of care will likely be successful in the long term.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="iso-abbrev">AIDS Patient Care STDS</journal-id>
<journal-id journal-id-type="publisher-id">apc</journal-id>
<journal-title-group><journal-title>AIDS Patient Care and STDs</journal-title>
</journal-title-group>
<issn pub-type="ppub">1087-2914</issn>
<issn pub-type="epub">1557-7449</issn>
<publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name>
<publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25692575</article-id>
<article-id pub-id-type="pmc">4410570</article-id>
<article-id pub-id-type="publisher-id">10.1089/apc.2014.0293</article-id>
<article-id pub-id-type="doi">10.1089/apc.2014.0293</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Behavioral and Psychosocial Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>A Qualitative Study of Patient Motivation to Adhere to Combination Antiretroviral Therapy in South Africa</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>van Loggerenberg</surname>
<given-names>Francois</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1,</sup>
</xref>
<xref ref-type="aff" rid="aff2"><sup>2,</sup>
</xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gray</surname>
<given-names>Debra</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gengiah</surname>
<given-names>Santhanalakshmi</given-names>
</name>
<degrees>MA</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kunene</surname>
<given-names>Pinky</given-names>
</name>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gengiah</surname>
<given-names>Tanuja N.</given-names>
</name>
<degrees>MClinPharm, MS</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Naidoo</surname>
<given-names>Kogieleum</given-names>
</name>
<degrees>MBChB</degrees>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Grant</surname>
<given-names>Alison D.</given-names>
</name>
<degrees>MBBS, PhD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<on-behalf-of>for the CAPRISA 058 Study Team</on-behalf-of>
<aff id="aff1"><label><sup>1</sup>
</label>
The Global Health Network, Centre for Tropical Medicine and Global Health,<institution>University of Oxford</institution>
, Oxford,<country>United Kingdom</country>
.</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
<institution>London School of Hygiene and Tropical Medicine</institution>
, London,<country>United Kingdom</country>
.</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
<institution>University of Winchester</institution>
, Winchester,<country>United Kingdom</country>
.</aff>
<aff id="aff4"><label><sup>4</sup>
</label>
CAPRISA,<institution>University of KwaZulu-Natal</institution>
, Durban,<country>South Africa</country>
.</aff>
</contrib-group>
<author-notes><corresp><addr-line>Address correspondence to:</addr-line>
<addr-line><italic>Dr. Francois van Loggerenberg</italic>
</addr-line>
<institution><italic>University of Oxford</italic>
</institution>
<addr-line><italic>The Global Health Network</italic>
</addr-line>
<addr-line><italic>Center for Tropical Medicine and Global Health</italic>
</addr-line>
<addr-line><italic>NDM Research Building</italic>
</addr-line>
<addr-line><italic>Old Road Campus</italic>
</addr-line>
<addr-line><italic>Oxford OX3 7FZ</italic>
</addr-line>
<country>United Kingdom</country>
<break></break>
<italic>E-mail:</italic>
<email xlink:href="mailto:francois.vanloggerenberg@ndm.ox.ac.uk">francois.vanloggerenberg@ndm.ox.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>01</day>
<month>5</month>
<year>2015</year>
<pmc-comment>string-date: May 2015</pmc-comment>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>5</month>
<year>2015</year>
<pmc-comment>string-date: May 2015</pmc-comment>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>29</volume>
<issue>5</issue>
<fpage>299</fpage>
<lpage>306</lpage>
<permissions><copyright-statement>Copyright 2015, Mary Ann Liebert, Inc.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="apc.2014.0293.pdf"></self-uri>
<abstract><title>Abstract</title>
<p>Taken as prescribed, that is, with high adherence, combination antiretroviral therapy (ART) has changed HIV infection and disease from being a sure predictor of death to a manageable chronic illness. Adherence, however, is difficult to achieve and maintain. The CAPRISA 058 study was conducted between 2007 and 2009 to test the efficacy of individualized motivational counselling to enhance ART adherence in South Africa. As part of the overall trial, a qualitative sub-study was conducted, including 30 individual interviews and four focus group discussions with patients in the first 9 months of ART initiation. Data were inductively analyzed, using thematic analysis, to identify themes central to ART adherence in this context. Four themes emerged that characterize the participants' experiences and high motivation to adhere to ART. Participants in this study were highly motivated to adhere, as they acknowledged that ART was ‘life-giving’, in the face of a large amount of morbidity and mortality. They were further supported by techniques of routine remembering, and highlighted the importance of good social support and access to supportive healthcare workers, to their continued success in negotiating their treatment. Participants in the current study told us that their adherence motivation is enhanced by free accessible care, approachable and supportive healthcare workers, broad social acceptance of ART, and past first-hand experiences with AIDS-related co-morbidity and mortality. Programs that include specific attention to these aspects of care will likely be successful in the long term.</p>
</abstract>
<counts><ref-count count="49"></ref-count>
<page-count count="8"></page-count>
</counts>
</article-meta>
</front>
</pmc>
</record>
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