Does antiretroviral therapy packaging matter? Perceptions and preferences of antiretroviral therapy packaging for people living with HIV in northern Tanzania
JournalPatient Preference and Adherence
PublisherDove Medical Press Ltd.
MetadataShow full item record
AbstractIntroduction: Despite improvements in treatment (eg, reduction in pill intake), antiretroviral therapy (ART) is dispensed in socially inefficient and uneconomical packaging. To make pills less conspicuous and decrease the risk of being stigmatized, people living with HIV (PLWH) often engage in self-repackaging - the practice of transferring ART from original packaging to alternative containers. This behavior has been associated with ART nonadherence and failure to achieve viral load suppression. While much of the literature on ART packaging has centered around medication adherence, patients stated preferences for ART packaging and packaging attributes that influence the observed ART nonadherence are understudied. Methods: We conducted a qualitative study to elucidate perceptions of ART packaging among PLWH at two large referral hospitals in Northern Tanzania. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed and coded. Results: Of the 16 participants whose data were used in the final analysis, a majority were between 36 and 55 years of age (Mean 45.5 years SD: 11.1), had primary-level education (n=11, 68.8%), were self-employed (n=9, 56.3%), reported that they had self-repacked ART (n=14, 88%), and were taking ART for more than 6 years (n=11, 68.8%). Participants identified three attributes of ART packaging that increased anticipated HIV stigma and prompted self-repackaging, including visual identification, bulkiness, and the rattling noise produced by ART pill bottles. Conclusion: Given the drastic reduction in the number of pills required for HIV treatment, there is an opportunity to not only assess the cost-effectiveness of innovative ART packaging but also evaluate the acceptability of such packaging among PLWH in order to address stigma and improve ART adherence. © 2020 Muiruri et al.
SponsorsThis research was supported by the National Institutes of Health-Fogarty International Center under Grant D43TW009595-01S1. We also acknowledge the support received from the Duke University Center for AIDS Research (5P30AI064518) and Diversity Supplement from the National Heart, Lung, and Blood Institute of the National Institutes of Health under Grant U01HL142099-01S1 and National Institute of Minority Health and Development Grant # R01 MD013493-01.
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85078676877&doi=10.2147%2fPPA.S238759&partnerID=40&md5=7447425cc7e71cd344079c09d90afeef; http://hdl.handle.net/10713/11701