Factors associated with antiretroviral treatment uptake and adherence: a review. Perspectives from Australia, Canada, and the United Kingdom

被引:37
作者
Bolsewicz, K. [1 ]
Debattista, J. [2 ]
Vallely, A. [3 ,4 ]
Whittaker, A. [5 ]
Fitzgerald, L. [1 ]
机构
[1] Univ Queensland, Sch Publ Hlth, Herston, Qld, Australia
[2] Metro North Hosp & Hlth Serv, Metro North Publ Hlth Unit, Windsor, Australia
[3] UNSW, Kirby Inst, Publ Hlth Intervent Res Grp, Sydney, NSW, Australia
[4] James Cook Univ, Australian Inst Trop Hlth & Med, Cairns, Australia
[5] Monash Univ, Fac Arts, Sch Social Sci, Melbourne, Vic 3004, Australia
来源
AIDS CARE-PSYCHOLOGICAL AND SOCIO-MEDICAL ASPECTS OF AIDS/HIV | 2015年 / 27卷 / 12期
基金
澳大利亚研究理事会;
关键词
ART; review; factors; Australia; Canada; UK; HIV CARE; MEDICATION ADHERENCE; SOCIAL-ISOLATION; DRUG-USERS; BARRIERS; PEOPLE; FACILITATORS; THERAPY; HEALTH; ADULTS;
D O I
10.1080/09540121.2015.1114992
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
International focus on reducing onward HIV transmission emphasizes the need for routine HIV testing and early uptake of antiretroviral treatment (ART). Strategic targets have been set for 2020 to achieve the goal of 90% of people infected with HIV diagnosed, 90% of identified cases on treatment, and 90% of persons on treatment virally suppressed (90-90-90). It is vital to understand the complexity of factors influencing a person's treatment decisions over time and the context which may enable better adherence. In this paper we present findings from the review of published and gray literature (2003-2013) on the documented factors associated with treatment initiation and adherence in the general adult population of Australia, Canada, and the UK. A framework developed by Begley, McLaws, Ross, and Gold [2008. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology. Clinical Psychologist, 12(1), 9-17] in Australia was adapted to summarize the findings. A systematic database search using keywords and a set of inclusion criteria yielded 17 studies (Australia=6; Canada=8; UK=3). In addition 11 reports were included in the review. We found that a person's abilities and motivations (intrapersonal factors, reported in 7 studies) to start and continue ART are influenced by a host of interconnected factors spanning relationship (interpersonal, 3 studies) and broader structural (extrapersonal, 15 studies) factors that are situated within social determinants of health. People therefore evaluate various costs and benefits of starting and staying on treatment, in which biomedical concerns play an important yet often subsidiary role. In this review the economic barriers to care were found to be significant and under-reported, highlighting the persistent health inequities in terms of access to services. Our understanding of the context around people's use of ART remains poor. Qualitative social research within HIV-positive communities is urgently needed to capture people's lived experiences and may address some of this deficit in understanding.
引用
收藏
页码:1429 / 1438
页数:10
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