A descriptive study to evaluate the effect of guidelines used by counsellors to improve adherence to antiretroviral therapy in the private sector

Abstract

A problem was identified at Aid for AIDS (AfA) whereby some doctors requested a change in treatment within less than a year after their patients started antiretroviral therapy. The requests were normally based on treatment failure. It appears that in most cases where the desired treatment outcome is not achieved is due to poor adherence to therapy. AfA is a HIV / AIDS disease management company offering access to antiretroviral therapy (ART), prevention of opportunistic infections, treatment and blood results monitoring, treatment support through adherence coordinators and expert clinical support and advice to healthcare providers. They monitor treatment adherence through claims history, CD4 and viral load (VL) results as well as telephonic contact with the client. Factors that could contribute to poor adherence are side - effects, barriers e.g. work environment, non - disclosure, lifestyle, lack of client commitment, limited contact between the client and treatment support counsellor, limited funds, stigmatisation and a lack of clear adherence guidelines to improve treatment outcome. Method: A comparative study was done to assess the impact of an intervention to improve patient adherence to ART. The researcher postulates that by the implementation of guidelines to counsellors, client adherence to therapy would increase. A comparative study was used to assess whether structured guidelines can improve client adherence to therapy. Results: The results have proven that guidelines used by treatment support counsellors does improve adherence to ART. Recommendations: It is recommended that treatment support counsellors, to improve their clients’ adherence to ART, should apply adherence guidelines.