The Association Between HIV Status Acceptance and Antiretroviral Adherence Among Recently Diagnosed Individuals in Coastal Kenya

Abuna, Mitchelle

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Year:: 2021
Contributor:: Abuna, Mitchelle (creator); Operario, Don (Advisor); McGarvey, Stephen (Reader); Brown University. School of Public Health (sponsor)
Genre:: theses
Subject:: HIV; ART adherence; HIV Status Acceptance
Extent:: iv, 36 p.

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Abstract:: Poor adherence to antiretroviral therapy (ART) is a key factor that determines low viral suppression, poor health, and potential ART resistance among people living with HIV (PLHIV). Proper uptake of care is especially important in low-resource settings where the impact of ART non-adherence can be profound. One theoretical factor that can potentially enhance uptake of care and ART adherence is the extent to which newly diagnosed PLHIV accept their HIV status. This mixed methods study analyzes the relationship between HIV status acceptance and ART adherence in Kilifi, Kenya, the country with the 4th largest HIV epidemic in the world. This study involved n=16 newly diagnosed PLHIV participants who participated in a longitudinal qualitative study as part of the Tambua Mapema Early Screening Programme. As part of the programme, newly diagnosed PLHIV were enrolled in care and their seronegative partners enrolled in PrEP. Four one-on-one in-depth interviews were conducted with PLHIV participants. The first interviews were conducted approximately 2 weeks after HIV diagnosis, with subsequent interviews taking place at 3, 6, 9, and 12 months during the participants’ medical follow-up visits. Viral loads were collected two weeks post diagnosis and at the 6-month mark. The final sample size of 16 was chosen purposively to include only recently diagnosed individuals who had their viral loads collected. The study analyzed interviews conducted during the 2nd week and 6th month assessments, to examine the relationship between status acceptance and uptake of medication. We found that a positive shift in acceptance of HIV-status was associated with decreased viral loads. The participants described multiple factors that helped them process their diagnosis. An encouraging support system, dependency of family, availability of effective medicine, increased knowledge, and spirituality enabled participants to move away from internalized stigma to developing positive outlooks on their HIV-status and complying with their ART regimen. These preliminary findings suggest that there is a necessity for further research to understand how HIV status accommodation influences the way individuals respond to treatment. An improved understanding will enable healthcare workers to provide more targeted, individualized support and counseling in the care of HIV.
Notes:: Thesis (Sc. M.)--Brown University, 2021

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Citation

Abuna, Mitchelle, "The Association Between HIV Status Acceptance and Antiretroviral Adherence Among Recently Diagnosed Individuals in Coastal Kenya" (2021). Public Health Theses and Dissertations. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:9epu54nt/

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Public Health Theses and Dissertations

Theses and Dissertations for the Public Health department.
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