Oral Abstract Presentations|
Clinical Trials in Resource-Limited Settings
Session Day and Time: Thursday 4 - 6:15 pm
Presentation Time: 4:15
Room: Ballroom C
Background: Little is known about assumptions of HIV-infected
patients (pts) regarding antiretroviral therapy (ART) as potential barrier to
ART adherence in resource-limited countries.
Methods: From 8/15/02 to 10/17/02, a cross-sectional study of HIV and ART knowledge, attitude, beliefs, and practices (KABP) was conducted at Chris Hani Baragwanath Hospital’s HIV Clinic in Soweto, South Africa. A random sample of pts answered a KABP questionnaire. Composite scores for HIV knowledge, ART knowledge, and socio-economic status (SES) were created. Chi-square tests as well as multivariate logistic or linear regressions were performed.
Results: Of 105 pts evaluated, 76 (72%) were women, mean age: 34, 104 (99%) Black African, 68 (65%) unemployed and 73 (69.5%) with education lower than a high school diploma. 74 (70%) were not on ART. 93 (89%) had good knowledge about the cause of HIV infection, 87(83%) about the mode of transmission, and 83 (79%) about the difference between HIV and AIDS. In multivariate linear regression (MLR) analysis, HIV knowledge score was not significantly associated with education, gender, age, marital status, employment status, or being on ART. Sixty-two (62; 59%) pts reported they were not worried about ART side effects; 68 (65%) agreed that missing ART doses leads to disease progression; 95 (90.5%) had disclosed their HIV status to one or more people; 87 (83%) and 78 (74%) reported they would not be worried about family or friends finding out if they take ART; 92 (90%) agreed that HIV can be controlled by ART; and 94 (89%) agreed that ART can prevent vertical transmission. Belief of HIV cure by ART was associated with low education (p < 0.001). However, ART knowledge score was not associated with age, gender, ART use, SES, or education in MLR analysis. Eighty-eight (88; 84%) pts reported condom use history. Report of past condom use decreased as age increased (AOR = 0.93; 95% CI, 0.88–0.99) and increased with increasing SES (AOR = 2.3; 95% CI, 1.1–4.8), but was not associated with gender, ART use, or marital status in a multivariate logistic regression model.
Conclusions: In our study population, baseline knowledge of cause of HIV, mode of transmission, perceived benefit of ART, as well as the importance of ART adherence was high. Whether these results translate to high ART adherence rates needs to be evaluated.