What effect does a support system have on treatment compliance among HIV-positive patients?
ABSTRACT
HIV- positive patients encounter various challenges in their daily life. Patients diagnosed with HIV face heath problem and the late adherence to treatment put them at risk for opportunistic infection and a short lifespan. Society is another big challenge that HIV positive patients faced, in some part of the World , reject and discrimination are part of the societal norm; this difficult environment does not encourage HIV patient to disclose their health status, which lead to the spread of disease and delayed treatment.
Research shows a correlation between the presence of a support system and improved quality of life for HIV positive individuals. When compared to individuals who do not disclose their positive HIV status, those with support also demonstrate better compliance with treatment, and therefore, more positive outcomes.
For more than two decades, antiretroviral therapy (ART) has been one of the standardized approaches in dealing with HIV-1 infections across Europe and America. The improvements in HIV treatments and its health care in 1996 included the prophylaxis for opportunistic infections and the management of comorbidities. For the same reason, it also improved intensive care management, disease screening, and health promotion. Likewise, researches also emphasize how education and robust support system can help HIV-positive patient start ART therapy on time and comply to the treatment can likely improves their lives.
INTRODUCTION
Support services for HIV positive patients are offered in a variety of settings and have been proven to have a significant positive impact. Many research studies have been done to examine community –based support and treatment advocacy programs about their effect on treatment adherence. HIV is the human immunodeficiency virus is a virus that attacks cells whose objective is to fight body infection which makes a person vulnerable to other diseases and infections. According to HIV.GOV (n.d.), the virus is spread through contact with bodily liquids of a certain person who had HIV. The most common way to spread the virus is through unprotected sex or sharing the injection equipment.
In history, the Centers for Disease Control (CDC) have reported as early as June 1981 of the presence of HIV cases in Los Angeles, California. The case in 1987 already resulted in the death of two American men. By 2018, the United States already has more than a million of its inhabitants confined with the virus (Heitz, 2018).
One of the treatments for HIV is the rapid initiation of antiretroviral therapy (ART). Mateo-Urdiales et al (2019) dissented the claim that despite the availability of ART, HIV continues to cause substantial illness and premature death in low and middle-income countries. Mateo-Urdiales et al (2019) found out that the employment of ART within a week’s diagnosis resulted in the improvement of the outcomes across the HIV treatment in low and middle-income settings.
In line with this, this paper aims to determine whether education about antiretroviral therapy (ART) treatment can improve adherence among HIV positive individuals who are non-adherent to treatment. Moreover, the objectives of this study are (1) to determine the effect of the support system and the relevance of ART compliance treatment in today’s HIV positive patients?; (2) to assess if there are further needs in the improvement for new HIV treatments; and (3) to evaluate the effectiveness of the ART treatment among adherent HIV patients.
Method
The researcher will employ a randomized controlled trial (RCT). According to Shiel Jr. (2018). RCT is defined as the research method in which people are to be selected randomly in receiving one of the several clinical interventions. One of the objectives of the randomized controlled trial is to compare the interventions used. Moreover, one of the interventions would have to be controlled. The controlled group could be one standard practice or employing no intervention at all. Furthermore, the people who participate in the study are called participants or subjects. The approach of RCT is quantitative because of its comparative and experimental nature. Moreover, whoever has the virus can be included in the study with no favored regard for children, adolescents, adults, men, women, or any gender.
The final sample had 150 participants, who had a mean age of 42. 5 year, 47% of the participants were women. Most of the Women were of African American descent. About 55% of the participants had received at least a high school education. 10% of the participants were employed fulltime and had a total monthly income that was less than $1000. 90% of the participants were sexually oriented as heterosexual. 5% were bisexual and 4% considered themselves explicitly homosexual. 15% were already married and their partners were aware of their current HIV-positive status. Over 50% reported having a stable sexual partner for about a year. 25% of the participants reported to have used illicit drugs in the course of the last six months. 65% of the participants confirmed to have started ART regimen two years before the clinical study.
Measures
A modified version of a social support inventory tool was utilized to assess the efficiency of the received social support for 45 days from families, friends and medical staff, the social support offered will be in the areas of emotional, appraisal, informational, emotional and spiritual support. Information support will revolve around enhancing the participants knowledge on ART. This is the only form of support that will be related to ART treatment. To measure medical adherence, a patient self-report for the last five days will be analyzed. There will be three measures of adherence, dose adherence, time adherence and pill adherence. For the three measures daily percentage of the three will be assessed.
The table below contain descriptive data on the main study variables of the 150 HIV positive participants.
|
Variables |
Mean(M) |
Standard Deviation (SD) |
Range |
|
Support received |
3.34 |
0.91 |
1-4 |
|
Depressive Symptomatology |
1.01 |
0.43 |
0-2.66 |
|
Stress |
1.25 |
0.45 |
0-3.50 |
|
Anxiety |
0.81 |
0.83 |
0-3.5 |
|
Self-efficacy |
4.65 |
0.93 |
1-4 |
|
Spiritual coping |
2.06 |
0.72 |
1-3 |
|
Time adherence |
0.75 |
0.45 |
0-1 |
|
Pill adherence |
0.73 |
0.23 |
0-1 |
|
Dose adherence |
0.90 |
0.34 |
0-1 |
Table 1.0 Descriptive Data
EXPECTED RESULT
The randomized controlled research is supposed to shows improvement on HIV-positive patient on ART compliance therapy as well as the advantage of having support system such as education, follow up appointment. The social desirability of the participants will be another factor that will be measured. Lastly, the results is supposed to show the effects of the support interventions offered.
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