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AuthorAhmed,Ali
AuthorDujaili,Juman Abdulelah
AuthorJabeen,Musarat
AuthorUmair,Malik Muhammad
AuthorChuah,Lay-Hong
AuthorHashmi,Furqan Khurshid
AuthorAwaisu,Ahmed
AuthorChaiyakunapruk,Nathorn
Available date2022-12-15T07:16:20Z
Publication Date2022
Publication NameFrontiers in Pharmacology
ResourceScopus
URIhttp://dx.doi.org/10.3389/fphar.2021.807446
URIhttp://hdl.handle.net/10576/37282
AbstractBackground: With the increased availability of safe antiretroviral therapy (ART) in recent years, achieving optimal adherence and patient retention is becoming the biggest challenge for people living with HIV (PLWH). Care retention is influenced by several socioeconomic, socio-cultural, and government policies during the COVID-19 pandemic. Therefore, we aim to explore barriers and facilitators to adherence to ART among PLWH in Pakistan in general and COVID-19 pandemic related in particular. Methods: Semi-structured interviews were conducted among 25 PLWH from December 2020 to April 2021 in the local language (Urdu) at the ART centre of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Interviews were audio-recorded in the local Urdu language, and bilingual expert (English, Urdu) transcribed verbatim, coded for themes and sub-themes, and analyzed using a phenomenological approach for thematic content analysis. Results: Stigma and discrimination, fear of HIV disclosure, economic constraints, forgetfulness, religion (Ramadan, spiritual healing), adverse drug reactions, lack of social support, alternative therapies, and COVID-19-related lock-down and fear of lesser COVID-19 care due to HIV associated stigma were identified as barriers affecting the retention in HIV care. At the same time, positive social support, family responsibilities, use of reminders, the beneficial impact of ART, and initiation of telephone consultations, courier delivery, and long-term delivery of antiretrovirals during COVID-19 were identified as facilitators of HIV retention. Conclusion: Improving adherence and retention is even more challenging due to COVID-19; therefore, it requires the integration of enhanced access to treatment with improved employment and social support. HIV care providers must understand these reported factors comprehensively and treat patients accordingly to ensure the continuum of HIV care. A coordinated approach including different stakeholders is required to facilitate patient retention in HIV care and consequently improve the clinical outcomes of PLWH. Copyright 2022 Ahmed, Dujaili, Jabeen, Umair, Chuah, Hashmi, Awaisu and Chaiyakunapruk.
SponsorWe thank the National AIDS Control Programme of Pakistan, and the HIV case manager (Hassan Mansoor Malik) of PIMS Hospital, for assisting us with data collection and the smooth running of the study. We would also like to thank Dr. Rabia Hussain for her suggestions in the development of the interview guide and HIV patients for their voluntary participation in the study.
Languageen
PublisherFrontiers Media S.A.
Subjectantiretrovirals
barriers and facilitative factors
challenges
interventions
Pakistan
people living with HIV/AIDS
UNAIDS
TitleBarriers and Enablers for Adherence to Antiretroviral Therapy Among People Living With HIV/AIDS in the Era of COVID-19: A Qualitative Study From Pakistan
TypeArticle
Volume Number12
dc.accessType Open Access


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