Racing to Keep Resistant HIV At Bay
UN Integrated Regional Information Networks NEWS
June 13, 2006
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Successful Adherence To AIDS Treatment Program
Botswana began enrolling patients in a nationwide antiretroviral (ARV) program in 2002. A treatment adherence and drug resistance study by the Botswana-Harvard AIDS Institute four years later shows
- 85 percent of patients are receiving treatment
- Little evidence of treatment fatigue
- Better or at least the equivalent adherence of their western counterparts
In a separate finding, the Infectious Diseases Care Clinic (IDCC) at Princess Marina Hospital in Gaborone reported that only 4% of the clinic’s 14,000 patients have had to be switched to second or third-line regimens.
Research Studies
Statistical analyses of two officially administered adherence strategies are underway with results expected in a year:
- Matching patients with a ‘buddy’ who supports their adherence
- Directly observed treatment (DOT) similar to the system used with TB patients
A pilot study by Sara Nam of the London School of Hygiene & Tropical Medicine indicated that adherence was influenced less by socioeconomic standing than by psychological and emotional issues similar to those of patients in developed countries: patients’ acceptance of their HIV status, their social support, and faith in their medical care.
Other Possible Causes Of Enhanced Adherence
Other tactics and advantages that may play a role in the high adherence rate in Botswana include
- Inundating patients with information and adherence counseling services
- Extensive fiscal resources devoted to AIDS treatment
- Intensive, insistent monitoring viral loads
Commentary
While Botswana does enjoy many advantages, especially in terms of fiscal resources, not available to other low-income countries, the fact that enough resources used appropriately can result in successful adherence and treatment results is worthy not only of not but celebration.