Antiretroviral Treatment in Sub-Saharan Africa

Alemu

Description

The introduction of antiretroviral therapy (ART) in middle and low income countries is arguably one of the most meaningful outcomes recorded in the fight against HIV and AIDS. A record number of some 6.2 million people living with HIV and AIDS are reported to be benefiting from the treatment, which is reported to have risen by 19 per cent between 2010 and 2011 and as a result of this, the region has also enjoyed a significant decline in AIDS mortality. This volume is the outcome of the �call for abstracts� put out by OSSREA in 2011 for senior researchers, social scientists and practitioners to write scientific articles on issues surrounding ARVs. The volume contains eight chapters organized into four sections: ART and quality of life; Adherence to ART; Traditional medicine and ART; and Sexual behaviour of ART attendants. The chapters are contributed by Academics and researchers from three different African countries: four from Ethiopia, two from Uganda and two from Zimbabwe.

Sujets

• Desierto del Sahara
• Sahara
• Sociology

Informations

• Publié par: OSSREA
• Date de parution: 13 mai 2013
• Nombre de lectures: 0
• EAN13: 9789994455782
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Edited by
ANTIRETROVIRAL TREATMENT IN SUB-SAHARAN AFRICA
Getnet Tizazu and Rahel Mesfn
Organisation for Social Science Research in
Eastern and Southern Africa (OSSREA)ANTIRETROVIRAL TREATMENT
IN
SUB-SAHARAN AFRICA
CHALLENGES AND PROSPECTS









Organisation for Social Science Research in
Eastern and Southern Africa (OSSREA)

© 2013 Organisation for Social Science Research in Eastern and Southern Africa
(OSSREA)
OSSREA acknowledges the support of Swedish International Development
Cooperation Agency (Sida), Norwegian Agency for Development Co-operation
(NORAD), The Netherlands Ministry of European Affairs and International
Cooperation, International Development Research Centre (IDRC), and Danish
Development Agency (DANIDA).


Printed in Ethiopia
All rights reserved.
ISBN: 978-99944-55-70-6

Edited by: Getnet Tizazu and Rahel Mesfin
Copy-edited at OSSREA
Text layout: Alemtsehay Zewde


Organisation for Social Science Research in Eastern and Southern Africa
P.O. Box 31971, Addis Ababa, Ethiopia
Fax: [phone]
Tel: [phone]
E-mail: [e-mail]
Website: www.ossrea.net



Table of Contents
vi Acronyms
Chapter One Introduction 1
Getnet Tizazu Fetene
Chapter Two Adherence to Antiretroviral Therapy in sub-Saharan 15
Africa: Challenges and Prospects
Sibhatu Biadgilign and Ayalu Aklilu
Chapter Three Quality of Life among Patients Living with HIV AIDS 39
in Sub-Saharan Africa
Francis Bajunirwe
Chapter Four Religion, Stigma and ART Adherence in Ethiopia: The 67
Experience of Ethiopian Religious Associations of
People Living with HIV and AIDS
Bereket Tarekegn
Chapter Five Determinants of Adherence to Antiretroviral Therapy 87
Drugs in the Phase of Rapid Scale-up of Antiretroviral
Treatment in sub-Saharan Africa: The Case of Ethiopia
Woinishet Asnake Sisay and Abiy Ayalew Alemayehu
Chapter Six Determinants of Access to Treatments by AIDS Patients 113
in Uganda
Joseph Wasswa-Matovu
Chapter Seven Traditional Medicine and HIV and AIDS Treatment: 139
Challenges, Prospects and Lessons for Zimbabwe
Enock Mandizadza and Gordon Chavunduka
Chapter Eight The Ambivalent Patient: A Study of Patients’ Attitudes 165
and Perceptions Towards ARVs and Traditional
Medicines or Faith Healing for Managing HIV and
AIDS Illness in Rural Harare, Zimbabwe
Shastry Njeru
Chapter Nine Sexual Behaviour of People Attending Anti-retroviral 193
Therapy in Addis Ababa
Nathan Negussie
Chapter Ten Concluding Remarks 211
Getnet Tizazu Fetene and Rahel Mesfin vi Antiretroviral Treatment in sub-Saharan Africa
Acronyms

AIDS Acquired Immune Deficiency Syndrome
AMR Adaptive Multi-Rate
ART Antiretroviral therapy
ART Antiretroviral Treatment
ARV Antiretroviral
BCC Behavioural Change Communication
BHPs Biomedical Health Practitioners
BMPs BiomediPractitioners
CBOs Community-based Organizations
CET Cardio-respiratoryExercise Training
CORPs Community-owned Resource Persons
CSA Central Statistical Agency
CSOs Civil Society Organizations
DCA Danish Church Aid
EECMY Ethiopian Evangelical Church Mekane Yesus
EIASC Ethiopian Islamic Affairs Supreme Council
EIFDDA Ethiopian Inter-faith Forum for Development, Dialogue and Action
EOC Ethiopian Orthodox Church
ETNEREL Ethiopian Network ofReligious Leaders Living with or Personally
A+ Affected by HIV and AIDS
EWB Existential Well-being
FBOs Faith-based Organizations
FHAPCO Federal HIV/AIDS Prevention and Control Office
FMOH Federal Ministry of Health
HAART Highly Active Antiretroviral Therapy
HAPCO HIV/AIDS Prevention & Control Office
HAPCSO HIV/AIDS Prevention, Care and Support Organization
HBV Hepatitis B
HC Health Centre
HCV Hepatitis C
HCT HIV Counselling and Testing
HIV Human Immuno-deficiency Virus
HRQL Health-related quality of life Acronyms
HSS HIV Symptom Scale
IAS International AIDS Society
IEC Information Education and Communication
IGA Income generation activity
IPA Interpretative Phenomenological Analysis
KAP Knowledge, attitude and practice
KS Kaposis sarcoma
MEMS Medication Event Monitoring Systems
MHS Mental Health Summary
MOH Ministry of Health
MOS Medical Outcomes Study
MOS-HIV Medical Outcomes Study HIV Health Survey
MVQOLI Missoula Vitas Quality of Life Index
NAC National AIDS Council
NCDs Non-communicable diseases
NCS Nutrition care and support
NGOs Non-governmental organizations
OIs Opportunistic infections
OLS Ordinary Least Square
OVC Orphan and Vulnerable Children
PHS Physical Health Summary
PLHIV People Living with HIV and AIDS
PLWHA People Living with HIV/AIDS
PMTCT Prevention of Mother-to-Child Transmission
PSD Psychosocial distress
QOL Quality of life
RWB Religious well-being
SDD Stigma, denial and discrimination
SNNPR Southern Nations, Nationalities and Peoples Region
SSDDIM Stigma, shame, discrimination, denial, inaction and mis-action
STIs Sexually transmitted infections
TASO The AIDS Support Organisation
TAWG Tanga AIDS Working Group
TB Tuberculosis viii Antiretroviral Treatment in sub-Saharan Africa
TBA Traditional birth attendants
THPs Traditional health practitioners
TMPC TraditionMedical Practitioners Council
TMPs Traditional medical practitioners
ToT Training of trainers
UAC Uganda AIDS Commission
UNAIDS United Nations Joint Programme on HIV/AIDS
UNESCO United Nations Educational, Scientific and Cultural Organization
UNICEF United Nations International Children’s and Educational Fund
VCT Voluntary Counselling and Testing
WHO World Health Organization
ZINATHA Zimbabwe National Traditional Healers Association





CHAPTER ONE
Introduction
Getnet Tizazu Fetene

The introduction of antiretroviral therapy (ART) in middle- and
lowincome countries is arguably one of the most meaningful outcomes
recorded in the fight against HIV and AIDS. Thanks to the expansion of the
therapy in these countries, fewer and fewer people are dying as a result of
HIV and AIDS related causes. In other words, despite apparent expansion
of ART that enabled eight million people worldwide to receive the
treatment, it is reported that it is in the Sub-Saharan Africa, the region hit
hardest, that the most dramatic progress has been observed (UNAIDS
2012). A record number of some 6.2 million people living with HIV and
AIDS are reported to be benefiting from the treatment, which is reported to
have risen by 19 per cent between 2010 and 2011 (Ibid. 19). As a result of
this, the region has also enjoyed a significant decline in AIDS mortality.
The number of AIDS-related deaths, which was frighteningly 1.8 million in
the year 2005, has dropped to 1.2 million in 2011 (UNAIDS 2012). So has
morbidity. All this is good news, and the success stories are largely
attributable to the rapid expansion of ART.
Irrespective of these encouraging trends, a number of challenges/problems
have been encountered following the introduction of ART and in relation to
its expansion. The need to maintain/achieve equitable access, failure to
reach those who haven’t known their sero-status, and difficulty of
convincing people living with HIV and AIDS (PLWHA), who are reluctant
to receive the therapy until they see AIDS-related illness, are some of the
challenges observed along the expansion of ART. Poor adherence (often
leading to drug resistance), complete discontinuation of the treatment, some
long-term and short-term side-effects resulting from ART management, are
other key problems occurring following ARV (antiretroviral) therapy. The
issue of maintaining the pace at which HIV treatment is currently
expanding is also another related challenge (Ivers, Kendrick, and Doucett
2005; UNAIDS 2012).
Mostly inspired by the need to find ways of tackling these challenges,
researchers and scholars in the developed and the developing world have
been conducting various studies on ART-related issues. Even though there
appears to be a consensus among them regarding the obvious benefits of
ARV therapy, they disagree on a number of other issues, for example on
measuring level of adherence among patients, on reasons for poor
adherence, on the role of traditional medicine in HIV treatment, and on
relevant methods of conducting related studies (Ivers, Kendrick, and
Doucett 2005). The debates on these issues are ongoing and they are likely
to continue.
x
x
x
x

2 Antiretroviral Treatment in sub-Saharan Africa
At this juncture, it is perhaps worth citing some specific areas of ARV
treatment that attracted scholars’ and researchers’ attention. Mostly because
of the negative repercussions poor adherence can bring about at societal
and individual levels, it could be argued that the issue of adherence is
perhaps one of the areas that have been wid