AFRICA: Major improvements needed to retain patients on ARVs

Source:IRIN/PlusNews
Photos:Anthony Kaminju/IRIN

Article: AFRICA: Major improvements needed to retain patients on ARVs

*The following are Talking Points from the aforementioned article:

1) About a third of patients on antiretroviral (ARV) programmes in sub-Saharan Africa are being "lost" within two years of enrolment

2) "Loss to follow-up" - patients who missed clinic visits and failed to pick up their medication, followed by death - were the two main reasons for patients being lost from the system.

3) "Better tracing procedures, better understanding of loss to follow-up and earlier initiation of ART [antiretroviral therapy] to reduce mortality are needed if [patient] retention is to be improved,"

4) Adherence to medication for chronic illnesses averaged just 50 percent in developed countries.

Barriers to Retention
5) "Investment in healthcare systems across much of Africa is insufficient....There needs to be more social workers to reach people, even those who live in rural areas."

6) Many people stopped taking the medication because widespread poverty and food shortages meant they could not afford the quantity of food needed to consume with the drugs.

7) "Distance from health centres, transport costs, shortages of trained health professionals, irregular supply of drugs, poor monitoring systems - these are all issues,"

8) "Cost is also a barrier; even though the ARVs are free, people don't have the money to treat their opportunistic infections."

9) Stigma and discrimination against HIV-positive people, even by health professionals, also hindered patients from adhering to their drug regimens and seeking follow-up care.

10) Previous studies have shown that good adherence and outcomes from ART were possible in poor rural African settings, provided healthcare systems modified their interventions to take into account social and economic barriers.

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*Note the abovementioned excerpts are direct quotes from the article and thus all credit and references should be afforded to the authors/sources.