HRQoL dimensions affected by antiretroviral therapy: a qualitative study in HIV-infected Ugandans.
A high level of adherence is vital for minimizing risk of treatment failure among antiretroviral therapy (ART) recipients. This qualitative research investigates and documents experiences of treatment adherence and perceived changes in the quality of life of Ugandan adults receiving in ART. METHODS: 8 predetermined Focus Group Discussions, 4 with men and 4 with women were conducted with participants of the Development of Antiretroviral Therapy (DART) Trial who had taken ART for a year. RESULTS: Participants reported that myths and misconceptions surrounding the purpose, effectiveness and side effects of ART initially convoluted their decision to seek ART. However, their deteriorating health compelled them to enrol for ART. Drug trust was established through A-110 the clear dosages, expiry date, and the perception that ART was manufactured professionally and hygienically unlike traditional herbal medicine. ART was reported to reduce disease symptoms and restore their physical strength thus enhancing their mobility, enabling them to resume their usual activities and care for themselves. Most importantly, ART had restored their self-esteem, hope and overall improved their quality of life, relieving them of depression and thoughts of death. Nevertheless, the positive effects of ART were limited by the high pill burden, treatment fatigue, and anxiety generated each time they needed to take the pills for those that had not disclosed their status. In addition, the visible side effects of ART, including change in colour of their nails, portrayed them as ART recipients thus exposing their HIV status and exacerbating stigma, which was described as an emotional encumbrance. CONCLUSIONS: ART improves the overall quality of life; however this positive gain is limited by the drug side-effects, pill burden and the likelihood of sero-status exposure. ART programmes should reinforce adherence through continuous and effective counselling and address stigma at household and community level. These qualitative findings are being tested in a quantitative study.
Nyanzi Wakholi, B.; Medina Lara, A.; Munderi, P.; Gilks, C.F.; Grosskurth, H. HRQoL dimensions affected by antiretroviral therapy: a qualitative study in HIV-infected Ugandans. Presented at International Society of Quality of Life Research 13th annual conference, Lisbon, Portugal, 10-14 October 2006. (2006)