Adherence behavior and the impact of HAART on quality of life of Ugandan adults
Kalanzi, Dorothy Julliet Nansikombi
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AIDS is no longer a death sentence due to the availability of highly active antiretroviral drugs (HAART) used to treat HIV. The international community is increasing access of HAART to low-resource regions. However, treatment failure and disease progression due to sub-optimal adherence are a public health concern. This study examines adherence behavior and the impact of HAART on perceived quality of life. Data utilized in this study were collected in 2007 and the sample is composed of 70 participants between ages 18 and 64 that were currently on HAART, who were selected using convenience sampling and were affiliated with three HAART providing centers in Uganda. Thirty seven percent of the participants were soldiers and 63% were civilians. The average years of schooling were 9. Fifty six percent of the participants were female. The median monthly income of respondents was $28. Eighty two percent of the participants began HAART after 2004. Some of the questions addressed include: How are individuals on HAART adhering to treatment? What factors influence highly active antiretroviral drug adherence behavior? What factors influence life style recommendations adherence behavior? What is the impact of HAART on perceived physical and psychological health among individuals undergoing treatment? Lack of food was the major influential factor for skipping taking medication, and side effects had the least impact on skipping taking medication. Gender power imbalances, economic need and cultural beliefs increased adherence failure because they were a hindrance to the regular use of condoms, having sex with only one partner, or having good nutrition. The effects of HAART on perceived psychological health were reported to be somewhat less as compared to physical health. In reference to physical health, respondents testified of clinical gains. Although the majority of participants reported improvements in psychological health, numerous respondents expressed continued feelings of anxiety, fear, and loneliness. Theoretical and practical implications of the findings as well as direction for future research are also discussed.