Factors that Influence Highly Active Anti-retroviral Therapy (HAART) Adherence in a Muslim Region of Cameroon: A Qualitative Study

Abstract

Background: Adherence to Highly Active Anti-Retroviral Therapy (HAART), a key determinant to HIV associated morbidity and mortality remains a major challenge to HIV/AIDS care. For strategies to improve adherence to HAART to be successfully implemented, in-depth understanding of factors that influence adherence is necessary. Qualitative data with regards to factors affecting HAART adherence in Cameroon are very sparse. The present study describes the factors that influence HAART adherence in a Muslim region of Cameroon. Knowledge of these specific factors for HAART adherence in Cameroon will aid in the development of useful and needed interventions to promote improved HAART adherence in resource constrained settings like Cameroon. Methods: The research site was the Garoua Military Hospital HIV/AIDS adult care unit in the North Region of Cameroon. A purposive sampling technique was used in selecting 20 (8 male and 12 female) HIV positive patients on ART, aged 18-53 years or above on HAART for at least 6 months. Data were collected in August 2014, using face-to-face semi-structured in-depth interviews. Data were transcribed, organized and coded using a thematic analysis. Results: Financial barriers (with regard to charges for diagnosis and cost of transportation to refill drugs), Socio-cultural factors (with regard to stigma by, and discrimination from relatives and the community, or fear of being stigmatised when taking HAART at home or when receiving HAART from the healthcare provider at the HAART centre), Patients’ characteristics (with regard to forgetting one’s medication because of cultural and religious events), experience at the healthcare facility (regarding healthcare provider-patient relationship, working hours, drug disponibility and service delivery) and drug-related factors (with regard to side effects of HAART) were the main identified determinants of adherence. Conclusion: Implication of religious authorities to emphasize and educate patients on the importance of taking drugs regularly, needs more emphasis. Training of more community and social workers in the field of HIV/AIDS care and psychosocial support in Cameroon and emphasizing on the privacy of clients when they visit HAART dispensing services is a priority. Envisaging the use of cell phones to improve adherence in this area could be affordable, but requires further research.