The effect of substance uses on antiretroviral treatment adherence in primary health care

Background: Adherence to antiretroviral treatment (ART) is the primary factor determining how an individual responds to their treatment. Unfortunately, individuals who use substances experience suboptimal adherence to their treatment, but little is known about the exact effects of their use on ART a...

Full description

Saved in:
Bibliographic Details
Main Authors: Ramprakash Kaswa, Marietjie R. de Villiers
Format: Article
Language:English
Published: AOSIS 2023-03-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/5660
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849234184095137792
author Ramprakash Kaswa
Marietjie R. de Villiers
author_facet Ramprakash Kaswa
Marietjie R. de Villiers
author_sort Ramprakash Kaswa
collection DOAJ
description Background: Adherence to antiretroviral treatment (ART) is the primary factor determining how an individual responds to their treatment. Unfortunately, individuals who use substances experience suboptimal adherence to their treatment, but little is known about the exact effects of their use on ART adherence in primary health care settings. Methods: The authors used a prospective cohort study to evaluate substance use’s effects on ART adherence among people living with HIV (PLWH) who attend primary health care services in the Mthatha region of South Africa. Results: During the study period, 601 PLWH were followed up for 6 months. The participant’s mean age was 38.5 (standard deviation [s.d.] = 11) years, with a mean CD4 count of 491.7 (s.d. = 241). Suboptimal ART adherence and default rates were 20.2% and 9.3%, respectively. Among the substance users, suboptimal adherence to ART was statistically significantly higher than non-users (24.6% and 15.9%, respectively, p = 0.007). The authors also observed suboptimum ART adherence among people who presented with clinical comorbidities. Conclusion: Substance use has negatively affected ART adherence among PLWH who attend primary health care services in the Eastern Cape province of South Africa. Therefore, an integrated substance use management strategy in primary health care is recommended to achieve optimal adherence to ART. Contribution: Substance use disorder significantly affected the adherence to ART in primary health care. This is important since primary care is the gateway to the HIV care continuum. The study highlighted the role of integration of substance use management in primary care.
format Article
id doaj-art-baa4ac6780e74e9fbd6bea5f7c0a60b4
institution Kabale University
issn 2078-6190
2078-6204
language English
publishDate 2023-03-01
publisher AOSIS
record_format Article
series South African Family Practice
spelling doaj-art-baa4ac6780e74e9fbd6bea5f7c0a60b42025-08-20T04:03:13ZengAOSISSouth African Family Practice2078-61902078-62042023-03-01651e1e810.4102/safp.v65i1.56604318The effect of substance uses on antiretroviral treatment adherence in primary health careRamprakash Kaswa0Marietjie R. de Villiers1Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha, Eastern Cape, South Africa; and, Department of Family Medicine and Primary Care, Faculty of Health Sciences, Stellenbosch University, Cape TownDepartment of Family Medicine and Primary Care, Faculty of Health Sciences, Stellenbosch University, Cape TownBackground: Adherence to antiretroviral treatment (ART) is the primary factor determining how an individual responds to their treatment. Unfortunately, individuals who use substances experience suboptimal adherence to their treatment, but little is known about the exact effects of their use on ART adherence in primary health care settings. Methods: The authors used a prospective cohort study to evaluate substance use’s effects on ART adherence among people living with HIV (PLWH) who attend primary health care services in the Mthatha region of South Africa. Results: During the study period, 601 PLWH were followed up for 6 months. The participant’s mean age was 38.5 (standard deviation [s.d.] = 11) years, with a mean CD4 count of 491.7 (s.d. = 241). Suboptimal ART adherence and default rates were 20.2% and 9.3%, respectively. Among the substance users, suboptimal adherence to ART was statistically significantly higher than non-users (24.6% and 15.9%, respectively, p = 0.007). The authors also observed suboptimum ART adherence among people who presented with clinical comorbidities. Conclusion: Substance use has negatively affected ART adherence among PLWH who attend primary health care services in the Eastern Cape province of South Africa. Therefore, an integrated substance use management strategy in primary health care is recommended to achieve optimal adherence to ART. Contribution: Substance use disorder significantly affected the adherence to ART in primary health care. This is important since primary care is the gateway to the HIV care continuum. The study highlighted the role of integration of substance use management in primary care.https://safpj.co.za/index.php/safpj/article/view/5660artadherencecohort studyprimary careplwhsubstance use
spellingShingle Ramprakash Kaswa
Marietjie R. de Villiers
The effect of substance uses on antiretroviral treatment adherence in primary health care
South African Family Practice
art
adherence
cohort study
primary care
plwh
substance use
title The effect of substance uses on antiretroviral treatment adherence in primary health care
title_full The effect of substance uses on antiretroviral treatment adherence in primary health care
title_fullStr The effect of substance uses on antiretroviral treatment adherence in primary health care
title_full_unstemmed The effect of substance uses on antiretroviral treatment adherence in primary health care
title_short The effect of substance uses on antiretroviral treatment adherence in primary health care
title_sort effect of substance uses on antiretroviral treatment adherence in primary health care
topic art
adherence
cohort study
primary care
plwh
substance use
url https://safpj.co.za/index.php/safpj/article/view/5660
work_keys_str_mv AT ramprakashkaswa theeffectofsubstanceusesonantiretroviraltreatmentadherenceinprimaryhealthcare
AT marietjierdevilliers theeffectofsubstanceusesonantiretroviraltreatmentadherenceinprimaryhealthcare
AT ramprakashkaswa effectofsubstanceusesonantiretroviraltreatmentadherenceinprimaryhealthcare
AT marietjierdevilliers effectofsubstanceusesonantiretroviraltreatmentadherenceinprimaryhealthcare