Public sector antiretroviral treatment: the challenge of patient retention

Abstract

English: Compliance with follow-up is needed to ensure that the public sector antiretroviral treatment programme in South Africa is successful and sustainable. This paper investigates the nature of factors associated with the retention of public sector ART patients in the primary health care-driven model. Data from a cross-sectional survey among patients are used. Income and social support are important facilitators of patient retention. Yet, income may also impact negatively on patient retention where entire families rely on a single breadwinner for their livelihood. Substance and alcohol abuse and stigma, according to the evidence, may impede patient retention. Avenues for further research are proposed and suggestions are put forward as to possible solutions to these policy dilemmas.Afrikaans: Terapietrou met opvolg is noodsaaklik om te verseker dat die ART-program in die openbare sektor in Suid-Afrika suksesvol en volhoubaar is. Hierdie bydrae ondersoek die aard van faktore wat met die retensie van ART-pasiënte in die openbare sektor binne die primêre gesondheidsorggedrewe model geassosieer word. Data van ’n deursnee-opname onder pasiënte word gebruik. Inkomste en sosiale ondersteuning is belangrike fasiliteerders van pasiëntretensie. Nogtans kan inkomste ook negatief op pasiëntretensie inspeel waar hele gesinne van ’n enkele broodwinner vir lewensonderhoud afhanklik is. Volgens die bevindinge kan dwelm- en alkoholgebruik en stigma ook pasiëntretensie bemoeilik. Moontlikhede vir verdere navorsing word voorgestel en aanbevelings gemaak met betrekking tot moontlike oplossings vir hierdie beleidsdilemmas.