Explaining adherence success in sub-Saharan Africa: An ethnographic study
2009

Explaining Adherence Success in Sub-Saharan Africa

Sample size: 414 publication Evidence: moderate

Author Information

Author(s): Norma C. Ware, John Idoko, Sylvia Kaaya, Irene Andia Biraro, Monique A. Wyatt, Oche Agbaji, Guerino Chalamilla, David R. Bangsberg

Primary Institution: Harvard Medical School

Hypothesis

Why are adherence levels to antiretroviral therapy (ART) higher in sub-Saharan Africa compared to North America?

Conclusion

Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and preserving social capital in essential relationships.

Supporting Evidence

  • Patients often borrow money or beg for transport funds to attend clinic appointments.
  • Adherence is prioritized through social relationships that provide support and resources.
  • Health care providers and treatment partners play crucial roles in encouraging adherence.

Takeaway

People in Africa take their HIV medicine really well because they want to help their friends and family, even when it's hard to get to the doctor.

Methodology

The study used ethnographic research methods, including 414 in-person interviews and 136 field observations across three countries.

Limitations

The study's findings may not apply to all African contexts due to the continent's diversity.

Participant Demographics

{"patients":{"gender_ratio":"65% female","mean_age":38,"marital_status":"44% married or living with a partner","education":"57% completed primary school","health_stage":"65% met criteria for Stage III or IV disease"},"treatment_partners":{"gender_ratio":"56% female","mean_age":39,"marital_status":"73% married or living with a partner","education":"35% completed primary school"},"health_care_providers":{"gender_ratio":"64% female","mean_age":38,"professional_roles":{"physicians":"27%","nurses":"35%","counselors":"19%","pharmacists":"16%"}}}

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000011

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