TY - JOUR
T1 - Habit formation in support of antiretroviral medication adherence in clinic-enrolled HIV-infected adults
T2 - A qualitative assessment using free-listing and unstructured interviewing in Kampala, Uganda
AU - Jennings Mayo-Wilson, Larissa
AU - Devoto, Bianca
AU - Coleman, Jessica
AU - Mukasa, Barbara
AU - Shelton, Angela
AU - MacCarthy, Sarah
AU - Saya, Uzaib
AU - Chemusto, Harriet
AU - Linnemayr, Sebastian
N1 - Publisher Copyright:
© 2020 The Author(s).
PY - 2020/6/8
Y1 - 2020/6/8
N2 - Background: Despite initial high motivation, individuals receiving antiretroviral therapy (ART) for several years may experience incomplete adherence over time, increasing their risk of HIV-related morbidity and mortality. Habits, defined as automatic and regular practices, do not rely on conscious effort, and may therefore support high long-term ART adherence. Methods: This qualitative study contributes to the evidence on how clients with adherence problems remember and form habits to take ART medications. Free-listing and unstructured interviewing were used among 42 clinic-enrolled adults in Kampala, Uganda who were receiving ART and participating in a randomized clinical trial for treatment adherence (clinicaltrials.gov: NCT03494777). Data were coded and analyzed using inductive content analysis. Results: Findings indicated that clients' most routine habits (eating, bathing, sleeping) did not always occur at the same time or place, making it difficult to reliably link to pill-taking times. Efforts to improve ART habits included having a relative to ask about pill-taking, re-packaging medications, leaving medications in view, using alarms, carrying water, or linking pill-taking to radio/prayer schedules. Reported challenges were adhering to ART schedules during changing employment hours, social activities, and travel. Conclusion: While habit-forming interventions have the potential to improve ART adherence, targeting treatment-mature clients' existing routines may be crucial in this population.
AB - Background: Despite initial high motivation, individuals receiving antiretroviral therapy (ART) for several years may experience incomplete adherence over time, increasing their risk of HIV-related morbidity and mortality. Habits, defined as automatic and regular practices, do not rely on conscious effort, and may therefore support high long-term ART adherence. Methods: This qualitative study contributes to the evidence on how clients with adherence problems remember and form habits to take ART medications. Free-listing and unstructured interviewing were used among 42 clinic-enrolled adults in Kampala, Uganda who were receiving ART and participating in a randomized clinical trial for treatment adherence (clinicaltrials.gov: NCT03494777). Data were coded and analyzed using inductive content analysis. Results: Findings indicated that clients' most routine habits (eating, bathing, sleeping) did not always occur at the same time or place, making it difficult to reliably link to pill-taking times. Efforts to improve ART habits included having a relative to ask about pill-taking, re-packaging medications, leaving medications in view, using alarms, carrying water, or linking pill-taking to radio/prayer schedules. Reported challenges were adhering to ART schedules during changing employment hours, social activities, and travel. Conclusion: While habit-forming interventions have the potential to improve ART adherence, targeting treatment-mature clients' existing routines may be crucial in this population.
KW - ART
KW - Adherence
KW - Antiretroviral therapy
KW - HIV
KW - Habit formation
KW - Qualitative
KW - Uganda
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U2 - 10.1186/s12981-020-00283-2
DO - 10.1186/s12981-020-00283-2
M3 - Article
C2 - 32513192
AN - SCOPUS:85086356133
SN - 1742-6405
VL - 17
JO - AIDS Research and Therapy
JF - AIDS Research and Therapy
IS - 1
M1 - 30
ER -