Video observations of treatment administration to children on antiretroviral therapy in rural KwaZulu-Natal

Bibliographic Data

ID19442499
AuthorsBronwyne Coetzee (,), Bronwyne J Coetzee (0000-0003-1545-418X, Stellenbosch University, corresponding author), Ashraf Kagee (0000-0003-1241-2566, ,), Richard Bland (0000-0003-1675-9268, University of the Witwatersrand), Ruth Bland (Africa Centre for Population Health, KwaZulu-Natal, South Africa)
Year2016
Volume28
Issuesup2
Pages34-41
Publication date2016-05-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2016.1176674
PMID27391997
OpenAlexW2460871468
LanguageEN
Citations received1
References cited25

For children younger than five years, caregivers are responsible for the measurement and administration of antiretroviral medication doses to children. Failure to adhere to the regimen as prescribed may lead to high viral loads (VLs), immune suppression and ultimately drug resistance. In the content of this study, adherence refers to adequate dosing of the medication by a caregiver. Acquired drug resistance to antiretroviral therapy (ART) is prevalent amongst children in South Africa, and poor adherence to the dosing regimen by caregivers may be associated with this problem. In this qualitative study, we purposively recruited 33 caregiver-child dyads from the Hlabisa HIV Treatment and Care Programme database. Children were divided into three groups based on their VL at the time of recruitment. Children with a VL ≥ 400 cps/ml were grouped as unsuppressed (n = 11); children with a VL ≤ 400 cps/ml were grouped as suppressed (n = 12); and children with no VL data were grouped as newly initiated (n = 10). Caregiver-child dyads were visited at their households twice to document, by means of video recording, how treatment was administered to the child. Observational notes and video recordings were entered into ATLAS.ti v 7 and analysed thematically. Results were interpreted through the lens of Ecological Systems Theory and the information-motivation-behavioural skills model was used to understand and reflect on several of the factors influencing adherence within the child's immediate environment as identified in this study. Thematic video analysis indicated context- and medication-related factors influencing ART adherence. Although the majority of children in this sample took their medicine successfully, caregivers experienced several challenges with the preparation and administration of the medications. In the context of emerging drug resistance, efforts are needed to carefully monitor caregiver knowledge of treatment administration by healthcare workers during monthly clinic visits

Antiretroviral therapy · Family medicine · Geography · Political science · Socioeconomics · Sociology · Viral load · Adolescent Sexual and Reproductive Health · HIV/AIDS Impact and Responses · HIV/AIDS Research and Interventions · Medicine