Barriers and facilitators of adherence to TB treatment in patients on concomitant TB and HIV treatment: a qualitative study

Gebremariam, Mekdes K.; Bjune, Gunnar A.; Frich, Jan C.
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p651
Academic Journal
Background: Tuberculosis is a major public health problem in Ethiopia, and a high number of TB patients are co-infected with HIV. There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment. The aim of the present study is to explore patients' and health care professionals' views about barriers and facilitators to TB treatment adherence in TB/HIV co-infected patients on concomitant treatment for TB and HIV. Methods: Qualitative study using in-depth interviews with 15 TB/HIV co-infected patients and 9 health professionals and focus group discussions with 14 co-infected patients. Results: We found that interplay of factors is involved in the decision making about medication intake. Factors that influenced adherence to TB treatment positively were beliefs in the curability of TB, beliefs in the severity of TB in the presence of HIV infection and support from families and health professionals. Barriers to treatment adherence were experiencing side effects, pill burden, economic constraints, lack of food, stigma with lack of disclosure, and lack of adequate communication with health professionals. Conclusion: Health professionals and policy makers should be aware of factors influencing TB treatment in TB/HIV co-infected patients on concomitant treatment for TB and HIV. Our results suggest that provision of food and minimal financial support might facilitate adherence. Counseling might also facilitate adherence, in particular for those who start ART in the early phases of TB treatment, and beliefs related to side-effects and pill burden should be addressed. Information to the public may reduce TB and HIV related stigma.


Related Articles

  • What Are the Reasons for Poor Uptake of HIV Testing among Patients with TB in an Eastern India District? Bishnu, Bipra; Bhaduri, Sudipto; Kumar, Ajay M. V.; Click, Eleanor S.; Chadha, Vineet Kumar; Satyanarayana, Srinath; Nair, Sreenivas Achutan; Gupta, Devesh; Ahmed, Quazi T.; Sarkar, Silajit; Paul, Durba; Dewan, Puneet // PLoS ONE;Mar2013, Vol. 8 Issue 3, p1 

    Background: National policy in India recommends HIV testing of all patients with TB. In West Bengal state, only 28% of patients with TB were tested for HIV between April-June, 2010. We conducted a cross-sectional survey to understand patient, provider and health system related factors...

  • Public health triangulation: approach and application to synthesizing data to understand national and local HIV epidemics. Rutherford, George W.; McFarland, William; Spindler, Hilary; White, Karen; Patel, Sadhna V.; Aberle-Grasse, John; Sabin, Keith; Smith, Nathan; Taché, Stephanie; Calleja-Garcia, Jesus M.; Stoneburner, Rand L. // BMC Public Health;2010, Vol. 10 Issue 1, p447 

    Background: Public health triangulation is a process for reviewing, synthesising and interpreting secondary data from multiple sources that bear on the same question to make public health decisions. It can be used to understand the dynamics of HIV transmission and to measure the impact of public...

  • Characteristics of HIV seroprevalence of visitors to public health centers under the national HIV surveillance system in Korea: cross sectional study. Mee-Kyung Kee; Jin-Hee Lee; Chaeshin Chu; Eun-Ju Lee; Sung-Soon Kim // BMC Public Health;2009, Vol. 9 Issue 1, p1 

    Background: In Korea, the cumulative number of HIV-infected individuals was smaller than those of other countries. Mandatory HIV tests, dominating method until 1990's, have been gradually changed to voluntary HIV tests. We investigated HIV seroprevalence status and its characteristics of...

  • Behaviour change in clients of health centre-based voluntary HIV counselling and testing services in Kenya. Arthur, G.; Nduba, V.; Forsythe, S.; Mutemi, R.; Odhiambo, J.; Gilks, C. // Sexually Transmitted Infections;Dec2007, Vol. 83 Issue 8, p541 

    Objective: To explore behaviour change, baseline risk behaviour, perception of risk, HIV disclosure and life events in health centre-based voluntary counselling and testing (VCT) clients. Design and setting: Single-arm prospective cohort with before-alter design at three (one urban and two...

  • HIV voluntary counselling and testing for African communities in London: learning from experiences in Kenya. Prost, A.; Sseruma, W. S.; Fakoya, I.; Arthur, G.; Taegtmeyer, M.; Njeri, A.; Fakoya, A.; Imrie, J. // Sexually Transmitted Infections;Dec2007, Vol. 83 Issue 8, p547 

    Objectives: To explore the feasibility and acceptability of translating a successful voluntary counselling and testing (VCT) service model from Kenya to African communities in London. Methods: Qualitative study with focus group discussions and a structured workshop with key informants. Five...

  • Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector. van Dongen, Johanna M.; Tompa, Emile; Clune, Laurie; Sarnocinska-Hart, Anna; Bongers, Paulien M.; van Tulder, Maurits W.; van der Beek, Allard J.; van Wier, Marieke F. // Implementation Science;2013, Vol. 8 Issue 1, p1 

    Background: Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific...

  • Retraction.  // Sexually Transmitted Infections;Aug2014, Vol. 90 Issue 5, p407 

    A correction to the article "P3.336 Seroprevalence of Human Immunodeficiency Virus (HIV) Infection Amongst Tuberculosis (TB) Patients Attending TB/DOTS Centre in Nnewi South East Nigeria" that was published in a 2013 issue is presented.

  • A quality improvement model for the rapid scale-up of a program to prevent mother-to-child HIV transmission in South Africa. Mate, Kedar S.; Ngubane, Gugu; Barker, Pierre M. // International Journal for Quality in Health Care;Sep2013, Vol. 25 Issue 4, p373 

    Quality problem and assessment In South Africa (SA), non-governmental organizations (NGOs) have a major role in the provision of health services, but they often compete for funding and influence rather than collaborate. The National Department of Health (NDOH) sought to coordinate existing...

  • Universal HIV Screening at a Major Metropolitan TB Clinic: HIV Prevalence and High-Risk Behaviors Among TB Patients. Weis, Stephen E.; Foresman, Brian; Cook, Peggy E.; Matty, Keith J. // American Journal of Public Health;Jan1999, Vol. 89 Issue 1, p73 

    Objectives. This study assessed the outcome of implementing a policy of universal screening of policy with tuberculosis (TB) for HIV infection at a major metropolitan public health TB clinic. Methods. HIV serologic testing was completed on 768 (93%) of 825 eligible patients. Ninety-eight...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics