Abstract #374  -  Adherence to Highly Active Antiretroviral Therapy (HAART): Challenges faced by Adolescents Living with HIV (ALWHA) in Botswana
Authors:   Presenting Author:   N Phalade -
Additional Authors:  Mr/s K Nthomang, Mr/s B Ngwenya, Mr/s N Seboni,
Aim: Background: Extraordinary efforts have been made to ensure universal access to antiretroviral therapy (ART) since its introduction in Botswana in 2002. The result was the slowing down of the deaths from AIDS over the years. HIV is no longer a death sentence. However, while we celebrate the positive results, the greatest challenge identified through numerous research studies is that a considerable number of people (including ALWHA) are still failing to adhere to HAART and thus placing themselves and others in danger as well as frustrating the government of Botswana efforts “no new HIV infections by 2016”. For HAART to provide long-term suppression of HIV replication, strict adherence to ART is critical. Failure to adhere to ART may enable the HIV to develop resistant mutations rendering HAART less ineffective. Research studies indicate that the success or failure to adhere to HAART is largely dependent on the expertise, collaboration and coordination of services within primary health care and social service support and delivery care systems. Aim: The purpose of this paper is to explore factors that impede as well as those that enhance effective adherence to HAART among ALWHA. Conceptual Framework: The theory of Reasoned Action and Planned Behavior was used to guide and inform the study to explore ALWHA salient beliefs and intentions to medication adherence.
Method / Issue: Methodology: A qualitative research design which utilizes focus groups and in-depth interviews and elicitation survey was conducted among sixteen (16) adolescents living with HIV and AIDS. This was followed by two focus group discussions comprising (an all male group and an all female group). In-depth interviews were conducted with twenty-five (25) health care providers and eight (8) parents/guardians of ALWA.
Results / Comments: The findings from the elicitation survey, FGDs and in-depth interviews shows adherence to HAART is a major problem for adolescents. ALWHA identified the following challenges to medication adherence, including; stigma and discrimination, HIV disclosure, and non-HIV disclosure, and interference with school activities.
Discussion: Adherence to HAART by ALWHA is problematic and a major challenge to effective utilization of the medication. It is therefore imperative to develop and implement HIV and STD risk reduction interventions. The interventions will focus on the design and promotion of information, communication and education targeting HIV prevention among ALWHA.
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