Based on a step-wedge randomized control trial (intervention n = 136; comparison n = 137), this study investigated the impact of a peer mentor intervention for youth living with HIV aged 15-24 years in Ndola, Zambia. Using piecewise hierarchical linear modeling (HLM), change in internalized stigma predicted change in mindfulness, and mindfulness was a significant predictor of better self-reported adherence to antiretroviral therapy (ART) across both intervention groups. Intervention group membership did not predict rate of change in mindfulness, but predicted a reduction in internalized stigma and an increase in self-reported ART adherence. Following the peer mentor intervention, internalized stigma was significantly lower in the intervention group than the comparison group. Findings highlight the need to develop and implement interventions specific to adolescents living with HIV with a biopsychosocial approach that attends to both the physical and psychological needs specific to adolescents. Our findings support the inclusion of mindfulness-based components in interventions targeting ART adherence for adolescents living with HIV.

This study sought to explore the views of healthcare workers regarding paediatric anti-retroviral therapy (ART) adherence in Nigeria. An exploratory descriptive qualitative research design was used to identify and describe healthcare workers’ views in Kano and Lagos, Nigeria. Three focus group discussions were held. The transcribed data was analysed using the framework approach of data analysis. Healthcare providers perceived poverty, illiteracy, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing ART adherence. Recommendations for enhancing paediatric ART adherence levels in Nigeria included: mainstreaming adherence counselling in paediatric ART and adopting a comprehensive family centred care approach were identified as measures for improving paediatric ART adherence. Other measures included free ART services, quality improvement in paediatric ART services, parental empowerment and stigma and discrimination reduction programmes. / Health Studies / M.A. (Public Health)

<p><font face="Times New Roman"> <p align="left"><font face="Times New Roman"><b><font face="Times New Roman">Aim</font><font face="Times New Roman">: To obtain baseline data on adherence levels and the major determinants of adherence among patients on HAART at Rundu Hospital, Namibia.</font></b></font></p> </font></p>

<p><font face="Times New Roman"> <p align="left"><font face="Times New Roman"><b><font face="Times New Roman">Aim</font><font face="Times New Roman">: To obtain baseline data on adherence levels and the major determinants of adherence among patients on HAART at Rundu Hospital, Namibia.</font></b></font></p> </font></p>

This study sought to explore the views of healthcare workers regarding paediatric anti-retroviral therapy (ART) adherence in Nigeria. An exploratory descriptive qualitative research design was used to identify and describe healthcare workers’ views in Kano and Lagos, Nigeria. Three focus group discussions were held. The transcribed data was analysed using the framework approach of data analysis. Healthcare providers perceived poverty, illiteracy, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing ART adherence. Recommendations for enhancing paediatric ART adherence levels in Nigeria included: mainstreaming adherence counselling in paediatric ART and adopting a comprehensive family centred care approach were identified as measures for improving paediatric ART adherence. Other measures included free ART services, quality improvement in paediatric ART services, parental empowerment and stigma and discrimination reduction programmes. / Health Studies / M.A. (Public Health)

Magister Public Health - MPH / Aim: To obtain baseline data on adherence levels and the major determinants of adherence among patients on HAART at Rundu Hospital, Namibia. Results: Seventy-eight percent of the 97 participants included in the study were female, resulting in a female to male ratio of 4 :1. The mean age of the participants was 36.7 (SD: 9.00) years with 80% of the participants being in the 20-44 age group. The mean duration on ART treatment was 20 (SD: 10.3) months with 76% of the participants being on ART for 24 or less months. The average adherence rate reported by mean composite of the three measures was 95.1%, while the proportion of patients who achieved adherence levels of 95% and above was 64%. The main barriers to adherence to HAART reported by participants were forgetfulness (28%), lack of food (13%) and being away from the pills (11%): facilitators reported included counselling (19%) and treatment supporters (11%). Having knowledge of the consequences of failing to take HAART as prescribed was significantly associated with adherence (p = 0.03), as was being female (p = 0.04) while living further than 6 km from the hospital was significantly associated with non adherence (p = 0.018).

This study attempted to identify personal (patient-related) factors influencing anti-retroviral therapy (ART) adherence in Addis Ababa, Ethiopia. A quantitative, descriptive, cross-sectional and analytical design was used. Structured interviews were conducted with 355 ART patients. The findings revealed that stigma, discrimination, depression and alcohol use negatively affected patients’ ART adherence levels. However, patients’ knowledge levels had no influence on their ART adherence levels, contrary to other researchers’ reports. Addressing stigma and discrimination at community levels might enhance patients’ abilities to take their medications in the presence of others. Healthcare professionals should be enabled to diagnose and treat depression among ART patients during the early stages. Non-adherent ART patients should be counseled about possible alcohol abuse. / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

This study attempted to identify personal (patient-related) factors influencing anti-retroviral therapy (ART) adherence in Addis Ababa, Ethiopia. A quantitative, descriptive, cross-sectional and analytical design was used. Structured interviews were conducted with 355 ART patients. The findings revealed that stigma, discrimination, depression and alcohol use negatively affected patients’ ART adherence levels. However, patients’ knowledge levels had no influence on their ART adherence levels, contrary to other researchers’ reports. Addressing stigma and discrimination at community levels might enhance patients’ abilities to take their medications in the presence of others. Healthcare professionals should be enabled to diagnose and treat depression among ART patients during the early stages. Non-adherent ART patients should be counseled about possible alcohol abuse. / Health Studies / M.A. (Public Health with specialisation in Medical Informatics)

MCur / Department of Advanced Nursing Science / Survival of children with HIV/AIDS has increased considerably with the use of effective antiretroviral therapy. However, the benefits of this therapy are limited by the difficulty of adherence to the treatment. This study sought to explore the role of professional nurses on anti-retroviral therapy adherence among children in Lejweleputswa district: Free State, South Africa. An exploratory descriptive qualitative research design was used to identify and describe role of professional nurses toward anti-retroviral therapy adherence among children. Population for this study included seventeen (17) professional nurses working in four purposively sampled Primary Health Care clinics invited to participate in the study. Four focus group discussions were conducted in which each group had 6 participants. The transcribed data was analysed using the framework approach of data analysis. Professional nurses in Lejweleputswa district report poor knowledge of parents/caregivers of children, perceived poverty, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing poor ART adherence. Recommendations for enhancing children ART adherence levels in Lejweleputswa district included: mainstreaming adherence counselling in children ART and adopting a comprehensive family centered care approach were identified as measures for improving children ART adherence. Other measures included integration of ART services into Primary Health Care (PHC) services, parental empowerment, development of a programme to reduce stigma and discrimination in the community.

The objective of the study was to identify the factors that affect the survival lifetime of HIV+ terminal patients in rural district hospitals of Albert Luthuli municipality in the Mpumalanga province of South Africa. A cohort of HIV+ terminal patients was retrospectively followed from 2010 to 2017 until a patient died, was lost to follow-up or was still alive at the end of the observation period. Nonparametric survival analysis and semiparametric survival analysis methods were used to analyse the data. Through Cox proportional hazards regression modelling, it was found that ART adherence (poor, fair, good), Age, Follow-up mass, Baseline sodium, Baseline viral load, Follow CD4 count by Treatment (Regimen 1) interaction and Follow-up lymphocyte by TB history (yes, no) interaction had significant effects on survival lifetime of HIV+ terminal patients (p-values<0.1). Furthermore, through quantile regression modelling, it was found that short, medium and long survival times of HIV+ patients, respectively represented by the 0.1, 0.5 and 0.9 quantiles, were not necessarily significantly affected by the same factors. / Statistics / M. Sc. (Statistics)