Social support and medication adherence in HIV disease in KwaZulu-Natal, South Africa

Busisiwe P Ncama, Patricia A McInerney, Busisiwe R Bhengu, Inge B Corless, Dean J Wantland, Patrice K Nicholas, Chris A McGibbon, Sheila M Davis
International Journal of Nursing Studies 2008, 45 (12): 1757-63

BACKGROUND: A supportive social environment is critical for those with HIV/AIDS. In KwaZulu-Natal, in South Africa, antiretroviral therapy is available to some HIV-positive individuals. Antiretroviral adherence is an important issue for limiting HIV infection. Adherence to therapy may be linked to social support, particularly amidst the stigma prevalent in HIV.

OBJECTIVE: The purpose of this study was to examine characteristics related to social support and antiretroviral medication adherence.

DESIGN: This cross-sectional, descriptive study explored the nature of the relationships among social support and other selected variables, including sociodemographic variables, quality of life, and adherence.

SETTINGS: After ethical review board approval, the sample of HIV-infected individuals who received care in outpatient clinics were recruited and completed the self-report instruments.

PARTICIPANTS: The sample included English and/or isiZulu-speaking (n=149) individuals over the age of 18 years receiving treatment for HIV/AIDS. A total of 149 patients with a diagnosis of HIV/AIDS agreed to participate and completed questionnaires after completing informed consent procedures. The study participants were recruited at four outpatient settings in Durban, KwaZulu-Natal province of South Africa.

METHODS: A descriptive, exploratory, cross-sectional design was utilized to explore the research questions: What are the characteristics of social support and the relationship to antiretroviral adherence in KwaZulu-Natal, South Africa? Descriptive statistics and regression analyses were used to answer the research questions.

RESULTS: Data analyses indicated that social support scores on the Medical Outcomes Study Social Support Survey were moderate (M=64.4; S.D.=14.7) among the study participants. The number of close friends and family were significantly correlated with a greater sense of social support. Despite this, the lowest scores on the quality-of-life measure using the Medical Outcomes Study Short Form 36 item survey were reported on the Social Functioning Scale.

CONCLUSIONS: In summary, the study findings suggest that a supportive social network is essential for those living with HIV/AIDS. However, social functioning and quality of life amidst the stigma of living with HIV in South Africa may be a concern and require further investigation.

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