Thesis (Ph. D. (Sociology)) -- University of Limpopo, 2014. / This study investigated the challenges to antiretroviral therapy adherence. Qualitative and
quantitative research methodologies were applied in the study. Purposive sampling was used
to select clients on antiretroviral therapy, convenience sampling was applied to select clients
who participated in the focus group discussions and health care workers and lay counsellors
were selected through the simple random sampling method. In-depth interviews were
conducted with 31 clients on antiretroviral therapy at 8 health facilities, 2 focus group
discussions comprising of 7 members each were conducted at two health facilities, medical
records of all respondents on antiretroviral therapy were reviewed and a stigma scale was
administered. A questionnaire was distributed amongst 17 health care workers and lay
counsellors.
Most of the respondents who participated in this study were females. Data gathered in this
study confirmed that women are more vulnerable to HIV than men. The majority of the
respondents were poor African people. The predominant language amongst the respondents
was the Xitsonga language; hence the world-view of the Va-Tsonga people was assessed.
HIV and AIDS cause many social problems in communities.
Some of the major findings are that:
Literacy levels were found to be very low as most of the respondents pointed out that they
had only obtained grade 7 or below. However, this did not have an impact on treatment
adherence. Some respondents indicated that they were unemployed; the majority said they
were employed.
Even though the stigma and discrimination experienced by the respondents was very low, the
few who experienced it had very traumatic and cruel experiences perpetrated by their own
family members and people in the community. In terms of disclosure, data indicates that
most people prefer disclosing to their mothers as they feel that they will get support. The
majority of the respondents disclosed to female family members and they were supported by
the people they disclosed to.
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Social support is very crucial for people who are on antiretroviral therapy (ART), most of the
respondents indicated that they had treatment supporters. Institutional support was very
minimal in that most pointed out that they did not belong to any support groups. There were
some who did not even know about the existence of any support groups at the health facilities
where they were receiving their treatment.
Most of the respondents indicated that they disclosed to their colleagues and others had not
as they feared that they would lose their jobs. Those who had disclosed indicated that they
needed support from their colleagues and employers with regard to compliance with their
clinic appointments. Most of the respondents had sexual partners, and had also disclosed to
their sexual partners, and disclosure was almost immediately after being diagnosed HIVpositive.
There are those who had not disclosed to their sexual partners as they feared
rejection or violent reaction. There were sero-discordant couples amongst the respondents
who supported each other regarding adherence. Most of the respondents indicated that they
had taken care of a family member living with HIV.
HIV prevalence also varies amongst health facilities. Strategies employed by health facilities
to monitor and evaluate HIV and AIDS programmes differ. Health Care Workers and lay
counsellors provided contrasting information. Primary Health Care facilities have been
accredited to provide ART, however the down-referral system seems to be failing as some
clinics now have more clients on ART than hospitals. Health Care Workers and counsellors
also need to be familiarized with the World Health Organization (WHO) standards. The level
of adherence acceptable for an individual on ART is 95%; there is however health facilities
that indicated the adherence level far below the required level.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ul/oai:ulspace.ul.ac.za:10386/1174 |
| Date | January 2014 |
| Creators | Mona, Tiny Petunia |
| Contributors | Mokhahlane, P. M., Sithole, S. L. |
| Publisher | University of Limpopo Turfloop Campus |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | xxxiii, 434 leaves |
| Relation | Adobe Acrobat Reader, version 7 |
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