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

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Citation

Jennings Mayo-Wilson, Larissa; Devoto, Bianca; Coleman, Jessica; Mukasa, Barbara; Shelton, Angela; MacCarthy, Sarah; Saya, Uzaib; Chemusto, Harriet; & Linnemayr, Sebastian (2020). 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. AIDS Research and Theapy, 17(1), 30. PMCID: PMC7278190

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.

URL

http://dx.doi.org/10.1186/s12981-020-00283-2

Reference Type

Journal Article

Year Published

2020

Journal Title

AIDS Research and Theapy

Author(s)

Jennings Mayo-Wilson, Larissa
Devoto, Bianca
Coleman, Jessica
Mukasa, Barbara
Shelton, Angela
MacCarthy, Sarah
Saya, Uzaib
Chemusto, Harriet
Linnemayr, Sebastian

Article Type

Regular

PMCID

PMC7278190

Data Set/Study

Behavioral Economics Incentives to Support HIV Treatment Adherence (BEST)

Continent/Country

Uganda

ORCiD

Mayo-Wilson - 0000-0001-9349-2283