Patient Adherence to Antiretroviral Therapy and its Relationship to Food Insecurity

Abstract

With an expanding programme for antiretroviral therapy (ART) in South Africa and other countries following new guidelines and goals from the World Health Organization and UNAIDS, it’s as important as ever to understand the barriers that exists for this treatment to be successful. This thesis investigates how economic vulnerability in the form of food insecurity affects adherence to treatment among HIV positive individuals on antiretroviral therapy in the uMgungundlovu District of KwaZulu Natal in South Africa. An increasing amount of literature identifies food insecurity as an important barrier to treatment adherence among people living with HIV (PLHIV) and this study has investigated if this is also the case in a region of South Africa that is highly resource restrained and where there is a high prevalence of HIV. Cross sectional data from a large study where over 10 000 people were interviewed was used, where food insecurity was reported on a household level and HIV positive respondents answered questions on adherence to treatment. Univariate and multivariate logistic regressions were run, finding significantly lower odds of adhering to ART when suffering from the highest degree of food insecurity (Multivariate analysis: O.R.=0.42, p<0.05). This thesis identifies members of the most severely food insecure households as a key population where nutritional support might positively affect adherence and thereby aid in the success of treatment programmes.