This paper considers the longer term impact of unplanned antiretroviral treatment interruptions in people with HIV and makes suggestions as to how they might be avoided and managed in future, based on a series of case studies (the 2007 public sector strike in South Africa, the ongoing political and economic crisis in Zimbabwe, and the 2008 floods in Mozambique). It has 5 sections, on the following subjects: 1) undesirable outcomes of sub-optimal adherence and the critical levels of adherence required to avoid these; 2) a review of studies on the effects of intended and unintended treatment interruptions; 3) levels of adherence which might be expected from patients in sub-Saharan Africa and the factors hindering such adherence; 4) the three crises mentioned above and their effects on ART delivery; and 5) potential strategies for keeping patients adherent on ART during a crisis situation.
Working Paper No. 247, jointly published by theCentre for Social Science Research, University of Cape Town, and Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa; ISBN 978-1-77011-187-5; 46 pp.
Unplanned ART treatment interruptions in Southern Africa: a literature review.