OBJECTIVE: To determine the level of and reasons associated with adherence to tuberculosis preventive therapy among asymptomatic HIV-infected individuals in northern Thailand. DESIGN: A prospective cohort study with a 9-month follow-up. METHODS: A total of 412 HIV-infected persons were enrolled in a tuberculosis preventive therapy programme in a hospital. A 9-month isoniazid regimen was prescribed. Adherence was determined by pill count. Participants who missed a scheduled appointment for more than a month were interviewed. Five focus group discussion sessions were held among those who successfully completed the therapy. RESULTS: Of the 412 participants, 69.4% (286) completed the 9-month regimen. The adherence rate, defined as the proportion of those who took more than 80% of pills, was 67.5% (n = 278). Sex, source of participants and history of physical symptoms were associated with adherence. A significant portion of defaults took place at the beginning of the therapy. Out-migration, denial of HIV status, and perceived side effects of isoniazid were frequently cited as reasons for non-adherence. For those adhering participants, the acceptance of personal HIV status, concern about children and family, and a good health provider relationship were important reasons motivating adherence. Several reminder systems were developed by the participants. CONCLUSIONS: Although a isoniazid preventive therapy programme was shown to be feasible, further adjustments on the selection of participants, enrollment process, and follow-up system based on these findings are necessary to increase the adherence.
OBJECTIVE: To determine the level of and reasons associated with adherence to tuberculosis preventive therapy among asymptomatic HIV-infected individuals in northern Thailand. DESIGN: A prospective cohort study with a 9-month follow-up. METHODS: A total of 412 HIV-infectedpersons were enrolled in a tuberculosis preventive therapy programme in a hospital. A 9-month isoniazid regimen was prescribed. Adherence was determined by pill count. Participants who missed a scheduled appointment for more than a month were interviewed. Five focus group discussion sessions were held among those who successfully completed the therapy. RESULTS: Of the 412 participants, 69.4% (286) completed the 9-month regimen. The adherence rate, defined as the proportion of those who took more than 80% of pills, was 67.5% (n = 278). Sex, source of participants and history of physical symptoms were associated with adherence. A significant portion of defaults took place at the beginning of the therapy. Out-migration, denial of HIV status, and perceived side effects of isoniazid were frequently cited as reasons for non-adherence. For those adhering participants, the acceptance of personal HIV status, concern about children and family, and a good health provider relationship were important reasons motivating adherence. Several reminder systems were developed by the participants. CONCLUSIONS: Although a isoniazid preventive therapy programme was shown to be feasible, further adjustments on the selection of participants, enrollment process, and follow-up system based on these findings are necessary to increase the adherence.
Entities:
Keywords:
Acquired Immunodeficiency Syndrome; Asia; Behavior; Developing Countries; Diseases; Drugs--therapeutic use; Hiv Infections; Infections; Prospective Studies; Research Methodology; Southeastern Asia; Studies; Thailand; Treatment; Tuberculosis--prevention and control; User Compliance; Viral Diseases
Authors: Sylvia M LaCourse; Ruth W Deya; Susan M Graham; Linnet N Masese; Walter Jaoko; Kischorchandra N Mandaliya; Julie Overbaugh; R Scott McClelland Journal: J Acquir Immune Defic Syndr Date: 2017-09-01 Impact factor: 3.731
Authors: Melbourne F Hovell; Carol L Sipan; Elaine J Blumberg; C Richard Hofstetter; Donald Slymen; Lawrence Friedman; Kathleen Moser; Norma J Kelley; Alicia Y Vera Journal: Am J Public Health Date: 2003-11 Impact factor: 9.308
Authors: A Crampin; S Kasimba; N J Mwaungulu; R Dacombe; S Floyd; J R Glynn; P E M Fine Journal: Trop Med Int Health Date: 2011-03-29 Impact factor: 2.622