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Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia

This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 201...

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Autores principales: Sawitri, Anak Agung Sagung, Sutarsa, I Nyoman, Merati, Ketut Tuti Parwati, Bakta, I Made, Wirawan, Dewa Nyoman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930988/
https://www.ncbi.nlm.nih.gov/pubmed/33562888
http://dx.doi.org/10.3390/idr13010015
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author Sawitri, Anak Agung Sagung
Sutarsa, I Nyoman
Merati, Ketut Tuti Parwati
Bakta, I Made
Wirawan, Dewa Nyoman
author_facet Sawitri, Anak Agung Sagung
Sutarsa, I Nyoman
Merati, Ketut Tuti Parwati
Bakta, I Made
Wirawan, Dewa Nyoman
author_sort Sawitri, Anak Agung Sagung
collection PubMed
description This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination).
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spelling pubmed-79309882021-03-05 Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia Sawitri, Anak Agung Sagung Sutarsa, I Nyoman Merati, Ketut Tuti Parwati Bakta, I Made Wirawan, Dewa Nyoman Infect Dis Rep Article This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination). MDPI 2021-02-05 /pmc/articles/PMC7930988/ /pubmed/33562888 http://dx.doi.org/10.3390/idr13010015 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sawitri, Anak Agung Sagung
Sutarsa, I Nyoman
Merati, Ketut Tuti Parwati
Bakta, I Made
Wirawan, Dewa Nyoman
Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title_full Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title_fullStr Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title_full_unstemmed Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title_short Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia
title_sort why counseling intervention fails to improve compliance towards antiretroviral therapy: findings from a mixed-methods study among people living with hiv in bali province, indonesia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930988/
https://www.ncbi.nlm.nih.gov/pubmed/33562888
http://dx.doi.org/10.3390/idr13010015
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