Perceptions about the acceptability of assessments of HIV medication adherence in Lilongwe, Malawi and Chennai, India

Steven A. Safren, N. Kumarasamy, Mina Hosseinipour, Meaghan M. Harwood, Irving Hoffman, Marybeth McCauley, Allan Jumbe, Christina Nyirenda, Matthew J. Mimiaga, Suniti Solomon, David Celentano, Kenneth H. Mayer

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Little research exists on acceptability issues related to assessments of adherence to ART in resource-poor settings. To help prepare for two large-scale, multisite ART intervention trials, this qualitative study of individuals in Chennai, India (49 men, 11 women; 33 taking ART, 27 not) and Lilongwe, Malawi (5 men, 5 women, all taking ART) examined potential limitations of different types of adherence assessments: an adherence questionnaire, a pill diary, a pillbox, an electronic pill cap, and a medication punch card. Many participants reported that the various assessments would be acceptable. Potential limitations included issues surrounding literacy, the desire to appease one's medical provider, privacy and stigma, and "cheating." These potential limitations are similar to the limitations of these assessments in Western settings. However, the data highlight the need to consider individual patient level concerns when assessing ART adherence in different cultural settings. Innovative ways of monitoring adherence while maintaining standardization across sites are required in multisite trials.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalAIDS and Behavior
Volume10
Issue number4
DOIs
StatePublished - Jul 1 2006
Externally publishedYes

Keywords

  • Adherence
  • Antiretroviral therapy
  • Developing countries
  • Qualitative research

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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