Background: ARV adherence is a strong predictor of biologic (virologic and immunologic) and
clinical outcomes in HIV, including quality of life, HIV progression, hospitalizations, and death.
Consistent adherence to antiretroviral therapy (ART) is the cornerstone of effective HIV
treatment. This study explores the interrelationship between food insecurity and access and
adherence to ARV treatment. Such studies will help inform policy maker in the study area on
ways of improving or maintaining adherence to ARV and scale up the treatment level.
Objective: The main objective of the study is to assess the prevalence of ARV adherence and
associated factors (with particular focus on household food insecurity) among urban PLHIV.
Method: PLHIV association based cross-sectional study was conducted from January, 2012 to
May, 2012 in Hawassa city. Both quantitative and qualitative data were used to triangulate one
with another. Adult PLWHA on ARV therapy for at least 3 months were the study participants.
A purposive sampling method used to select the study participants. Bivariate and multivariate
logistic regressions were computed to assess the factors associated with ARV therapy nonadherence
among adult PLHIV in the study area.
Result: Data were collected using structured questionnaire with open and closed type questions
where a total of 325 participants were interviewed. Two focus group discussions with 6- 8
members each were conducted. Key informant interviews for PLHIV association’s coordinator
and healthcare providers at ART clinic were conducted. Data was presented using frequency
tables and graphs. Data was analyzed using SPSS software version 16.0. Results show that that
the prevalence of adherence to ART was 82.5 %( that is non –adherence level 17.5%), was suboptimal(
less than 95%).Both dietary diversity and meal frequency score were less than mean (
48.6% and 60.6%) respectively. Based on household food insecurity access module (63.7%)
were food in secured. Household food insecurity was associated with ART adherence. Factors
significantly associated with non- adherence to ARV therapy were religious status, protestant
and catholic (COR 3.74, 95% CI 1.43-9.78) and (COR 2.11, 95%CI 1.11-4.02) respectively;
marital status, divorced (AOR 3.88(1.48-10.20).[...]
Table of Contents
1. Introduction
1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objectives of the Study
1.3.1 General Objective
1.3.2 Specific Objectives
1.4 Research Questions
1.5 Significance of the Study
1.6 Limitations of the Study
1.7 Organization of the Study
2. Literature Review
2.1 Theoretical framework on Food Security
2.1.1 Definition of Food Security
2.1.2 Concept of food security
2.1.3 Dimensions of food security
2.1.4 Measurement of household food insecurity
2.2 Conceptual Framework of Household food insecurity HIV/AIDS and ARV adherence
2.3 Perspective on Adherence
2.4 Antiretroviral Therapy Adherence
2.5 Measuring Adherence to ARV
3. Materials and Methods
3.1 Overview of Methodology
3.2 Description of the Study Area
3.3 Study and Sample Design
3.4 Study Population
3.5 Sampling Methods
3.6 Sample size and sampling procedures
3.7 Inclusion and Exclusion Criteria
3.8 Study Variables
3.8.1 Dependent and Independent Variables
3.9 Data type and Sources
3.10 Data quality control
3.11 Instrument of Data Collection
3.12 Data Management and Analysis
3.13 Ethical Consideration
3.14 Operational Definitions
4. Results and Discussion
4. Results
4.1. Quantitative Results
4.1.1 Socio-demographic and economic characteristics of study participants
4.1.2 Dietary Diversity,Meal Frequency and Household food insecurity situation of PLHIV
4.1.3 ART Adherence situation of study participants
4.1.4 Reasons for missing doses ARV regimen
4.2 Qualitative Results
4.2.1 Focus Group Discussions
4.2.2 In -depth Interviews
4.3 Discussion
5. Conclusions and Recommendations
5.1 Conclusions
5.2 Recommendations
Research Objectives and Key Topics
The primary objective of this study is to examine the prevalence of Antiretroviral Therapy (ART) adherence and identify associated factors, with a specific focus on the role of household food insecurity, among urban people living with HIV (PLHIV) in Hawassa City, Ethiopia.
- Interrelationship between food insecurity and ARV adherence.
- Socio-demographic and economic determinants of ART adherence.
- Methodological approaches to measuring household food security.
- Impact of nutritional status on treatment outcomes and immune system function.
- Strategic recommendations for integrating food support with HIV treatment programs.
Excerpt from the Book
1.2 Statement of the problem
Food security is immediate need for individuals, households and communities affected by HIV in developing countries. Lack of food security may enhance the progression to AIDS-related illnesses, undermine adherence and response to antiretroviral therapy, and exacerbate socioeconomic impacts of the virus. Shortage of food is reported to be one of the reasons for non-adherence to ART as the drugs were said to increase appetite (Hardon et al., 2006). HIV infection itself undermines food security by reducing work capacity and productivity, and jeopardizing household livelihoods (Gillespie S, Kadiyala S, 2005).
ARV can interact with food in variety of ways, resulting in negative outcome. Thus, it is critical to understand the specific interactions and implication of drugs taken. This understanding enables effective management of these interactions to maintain food security and improve drug efficacy and adherence. Food affects the efficacy of ARVs by affecting absorption, metabolism and distribution kinetics of the drugs. The side effects of ARV medications can also lead to reduced food intake and nutrient absorption that exacerbates the weight loss and nutritional problems of PLHIV (WHO, 2003). If not properly managed, these interactions result in reduced effectiveness of the therapy.
A person living with HIV/ AIDS therefore needs additional nutrients to help them fight off the virus and related opportunistic infections. It is important to note that individuals infected with HIV have special nutritional needs, such as increased energy requirements (FAO, 2002). Food insecurity is considered as one of the barriers to antiretroviral (ARV) therapy access and adherence in sub- Saharan Africa. But little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions .A combination of energy giving, body building and protective foods are essential (PANOS, 2007).
Summary of Chapters
Chapter One: This section introduces the global and local context of the HIV/AIDS epidemic, outlines the research objectives, and defines the scope and limitations of the study regarding ART adherence.
Chapter Two: This chapter provides a comprehensive literature review, establishing theoretical and conceptual frameworks linking food security, malnutrition, and ARV adherence.
Chapter Three: This section details the materials and methods used, including the study design, sampling procedures, data collection instruments, and ethical considerations employed in the research.
Chapter Four: This chapter presents the quantitative and qualitative findings of the study, covering demographic data, food security metrics, and factors influencing ART adherence, followed by a discussion of these results.
Chapter Five: This concluding chapter synthesizes the main research findings and provides targeted recommendations for policy makers and stakeholders to improve ART adherence through nutritional and social support.
Keywords
Antiretroviral therapy (ART), ARV, HIV/AIDS, PLHIV, food insecurity, household food insecurity access scale (HFIAS), dietary diversity, meal frequency, treatment adherence, Ethiopia, Hawassa, nutrition, socio-economic factors, immunodeficiency, public health.
Frequently Asked Questions
What is the core focus of this research?
The research investigates the relationship between household food insecurity and the adherence of urban people living with HIV (PLHIV) to their prescribed antiretroviral therapy (ART) in Hawassa, Ethiopia.
What are the primary themes addressed?
The study focuses on the impact of food access, dietary diversity, and meal frequency on treatment efficacy, alongside socio-demographic factors like religion, marital status, and education level.
What is the study's main research question?
The central question is whether a significant link exists between household food insecurity and the adherence to ARV therapy among the target population in Hawassa City.
Which scientific methods were employed?
The study utilized a cross-sectional, association-based method, combining quantitative surveys with qualitative data from focus group discussions and in-depth interviews with key informants.
What does the main body of the work cover?
It covers theoretical frameworks of food security, the conceptual relationship between HIV/AIDS and nutrition, detailed methodology for data collection in resource-limited settings, and an analysis of factors contributing to missed medication doses.
Which keywords best describe the paper?
The study is characterized by terms such as Antiretroviral therapy (ART), PLHIV, food insecurity, dietary diversity, treatment adherence, and public health interventions.
How does food insecurity specifically affect ART?
The study finds that lack of food is a primary reason for non-adherence, as patients struggle to take medication on an empty stomach or prioritize food for their children over their own nutritional and treatment needs.
What role does the level of education play in adherence?
The study results indicate a statistically significant positive relationship, where higher levels of education are associated with better understanding and consistent adherence to ART regimens.
What recommendation is made for religious institutions?
The study recommends that health facilities collaborate with religious institutions to address specific beliefs that may influence treatment adherence, as some religious groups showed higher rates of non-adherence in the findings.
- Citar trabajo
- Eyasu Desta Menamo (Autor), 2012, Impact of Household Food Insecurity on Adherence to Antiretroviral Therapy (ART) among Urban PLHIV, Múnich, GRIN Verlag, https://www.grin.com/document/208218
