Although antiretroviral (ARV) medicines do not provide a cure for HIV and AIDS and are associated with other problems such as side effects and drug resistance, they can increase the length and quality of life, as well as the productivity of patients on antiretroviral therapy (ART). Antiretroviral regimens have improved survival rates and lowered the incidence of opportunistic infections in people with AIDS. Strict adherence to ART is crucial in order to maintain a low viral load and to prevent the development of drug resistant strains of the virus. However, some patients do not return for follow-up on schedule and the likely outcome for such patients is sub-optimal adherence to prescribed ARV regimens and possible treatment failure.
Anthropological studies have shown that patientsâ explanatory models are necessary additions to the treatment criteria used by health providers (Kleinman, 1980 & 1988; Nanda & Warms, 2002). Kleinman et al. (1978) introduced the concept of the explanatory model in applying anthropological insight to clinical practice. They maintain that, in the health care encounter, patients and practitioners may be working with different and competing models. If not properly managed, such divergent and incongruent models may result in ineffective treatment or non-compliance (cf. Jones et al., 1998). If Eisenbergâs (1977) assumption that, âa patient suffers illnesses, and doctors diagnose and treat diseaseâ is correct then Kleinmanâs (1980) pursuit to reconcile the social and medical constructs of ill health is a worthy endeavour. Unfortunately, such a comprehensive approach is for the most part, lacking in the literature. In line with Kleinmanâs view, this study argued that, HIV and AIDS, ARV medication adherence, prevention programmes and treatment readiness training cannot be studied and understood without taking into account the individualâs explanatory models (situated within and constrained by social context), as well as how individuals construct an understanding of and imposes meaning on the world around them.
Given the importance of proper adherence management, the aim of this study was to conduct an ethnographic inquiry into the nature and role of individualsâ socio-cultural contexts in treatment adherence/non-adherence regardin antiretroviral treatment. In order to achieve this aim, three integrated ethnographic data collection methods, i.e., participant observation, in-depth interviews and focus group discussions were employed to better understand the socio-cultural context and experiential understanding of patients on ARV.
The results reinforced several important facts related to HIV and AIDS, ARV medication adherence, prevention programmes and treatment readiness training, and shed additional light on other areas of patient social interaction that might add value to current discourse/practices. The study concluded that patientsâ socio-cultural context provides crucial information that can be used not only to identify causal reasoning, understanding of ill health, treatment readiness training, prevention programmes and adherence to treatment, but to assist in ascertaining the most effective means of intervention within a particular society or community.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ufs/oai:etd.uovs.ac.za:etd-03222011-160447 |
| Date | 22 March 2011 |
| Creators | Serekoane, Motsaathebe |
| Contributors | Prof PA Erasmus |
| Publisher | University of the Free State |
| Source Sets | South African National ETD Portal |
| Language | en-uk |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.uovs.ac.za//theses/available/etd-03222011-160447/restricted/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University Free State or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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