Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Jun 8;17(1):30.
doi: 10.1186/s12981-020-00283-2.

Habit formation in support of antiretroviral medication adherence in clinic-enrolled HIV-infected adults: a qualitative assessment using free-listing and unstructured interviewing in Kampala, Uganda

Larissa Jennings Mayo-Wilson  1   2 , Bianca Devoto  3 , Jessica Coleman  3 , Barbara Mukasa  4 , Angela Shelton  3 , Sarah MacCarthy  5 , Uzaib Saya  5 , Harriet Chemusto  4 , Sebastian Linnemayr  5
Affiliations
Randomized Controlled Trial

Habit formation in support of antiretroviral medication adherence in clinic-enrolled HIV-infected adults: a qualitative assessment using free-listing and unstructured interviewing in Kampala, Uganda

Larissa Jennings Mayo-Wilson et al. AIDS Res Ther. .

Abstract

Background: Despite initial high motivation, individuals receiving antiretroviral therapy (ART) for several years may experience incomplete adherence over time, increasing their risk of HIV-related morbidity and mortality. Habits, defined as automatic and regular practices, do not rely on conscious effort, and may therefore support high long-term ART adherence.

Methods: This qualitative study contributes to the evidence on how clients with adherence problems remember and form habits to take ART medications. Free-listing and unstructured interviewing were used among 42 clinic-enrolled adults in Kampala, Uganda who were receiving ART and participating in a randomized clinical trial for treatment adherence (clinicaltrials.gov: NCT03494777). Data were coded and analyzed using inductive content analysis.

Results: Findings indicated that clients' most routine habits (eating, bathing, sleeping) did not always occur at the same time or place, making it difficult to reliably link to pill-taking times. Efforts to improve ART habits included having a relative to ask about pill-taking, re-packaging medications, leaving medications in view, using alarms, carrying water, or linking pill-taking to radio/prayer schedules. Reported challenges were adhering to ART schedules during changing employment hours, social activities, and travel.

Conclusion: While habit-forming interventions have the potential to improve ART adherence, targeting treatment-mature clients' existing routines may be crucial in this population.

Keywords: ART; Adherence; Antiretroviral therapy; HIV; Habit formation; Qualitative; Uganda.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. World Health Organization. Global Health Observatory (GHO) Data. Antiretroviral therapy (ART) coverage among all age groups. URL: https://www.who.int/gho/hiv/epidemic_response/ART_text/en/.
    1. UAIDS. Global HIV & AIDS statistics—2019 fact sheet. URL: https://www.unaids.org/en/resources/fact-sheet.
    1. Ortego C, Huedo-Medina TB, Llorca J, Sevilla L, Santos P, Rodríguez E, Warren MR, Vejo J. Adherence to highly active antiretroviral therapy (HAART): a meta-analysis. AIDS Behav. 2011;15(7):1381–1396. doi: 10.1007/s10461-011-9942-x. - DOI - PubMed
    1. Boender TS, Sigaloff KC, McMahon JH, Kiertiburanakul S, Jordan MR, Barcarolo J, et al. Long-term virological outcomes of first-line antiretroviral therapy for HIV-1 in low- and middle-income countries: a systematic review and meta-analysis. Clin Infect Dis. 2015;61(9):1453–1461. doi: 10.1093/cid/civ556. - DOI - PMC - PubMed
    1. Inzaule SC, Hamers RL, Kityo C, Rinke de Wit TF, Roura M. Long-term antiretroviral treatment adherence in HIV-infected adolescents and adults in Uganda: a qualitative study. PLoS One. 2016 Nov 29;11(11):e0167492. 10.1371/journal.pone.0167492. eCollection 2016. Erratum in: PLoS One. 2017;12 (2):e0172077. - PMC - PubMed

Publication types

Substances

Associated data