What Leads a Person to Stick to Their Treatment (or Not)?

According to the World Health Organization (WHO), the degree to which the behavior of a sick person coincides with the indications for treatment provided by medical personnel is known as adherence to treatment. 

It seems like a simple concept, but in practice it’s difficult to achieve for almost any type of disease and treatment. Even in 2003, WHO calculated that the adherence rate in people with chronic afflictions all over the world was only 50%.

Regarding HIV, treatment is crucial

In the case of HIV, adherence plays a crucial role because of two reasons: the first is that treatment must be carried out during the rest of the person’s life, the second is that if antiretroviral medications are not taken on time and as prescribed, this gives way for the virus to mutate and become resistant to the medications being taken, requiring to change the drug in order to obtain the same efficiency in treatment. 

A lot has been studied on the reasons why people abandon their treatment, as well as the ways in which we can contribute to reduce the rate of abandonment. 

Causes for abandonment

On the reasons for poor adherence, it is known that there are many factors that may influence. For example, a group of investigators in Spain listed the following from a study carried out:

  • Factors related to the patient: these may be the person’s socio-cultural environment, their level of education and even their personality; as well as other situations such as simply forgetting. 
  • Medication factors: one of the most common reasons for abandonment are the adverse effects, since they are bothersome and people prefer to avoid them. Another reason is the way the medication acts, this means that, if short term benefits are not perceived, it’s possible that they may stop taking them. And finally, the price of the medications may be a clear barrier in order to continue treatment. 
  • Factors related to the disease: for long term diseases such as HIV, there is a higher default rate because of the long period of time the treatment must be taken for, compared to any acute infection which only lasts a few weeks. 
  • Factors related to health personnel: having a bad relationship with the health staff, as well as difficulties in communication, may influence in treatment abandonment. 

Elements which favor adherence

However, not all is lost. There are elements which benefit therapy adherence and which have also been identified as factors worth encouraging. As exemplified by a group of investigators from the San Vicente de Paúl Hospital in Ecuador, when studying the population that attended to the AIDS clinic, from that institution. 

In 2016, 70% of their users were men and 74.4% of all the population who attended the clinic declared themselves as heterosexual. Besides, 40% of all the users were between 20 and 30 years old and 34.4% had reached a junior high school level of education. It was also observed that 66.7% of all the attending population presented a normal family function. 

The authors of the study concluded that the factors which favor a good adherence to treatment are: 

  • Family support (the low level of family dysfunction is relevant here) 
  • Higher level of education
  • Good relationship with the health personnel (which included empathy, honesty, support and respect that people stated they received from the clinic staff)
  • High level of knowledge of the disease and treatment (thanks to guidance documents that were delivered to people when they started their treatment) 

Looking at this scenario, the specialists recommended, among other actions, to encourage following up on adherence to treatment in each medical checkup, highlighting its importance as well as emphasizing the risks of not correctly complying with the treatment. 

This way, it was identified in practice, which are the really important factors that make a person not only access to, but also stay in treatment and follow it through. 

At AHF we offer linkage and accompaniment to treatment. If you already have a positive diagnosis, write to the closest AHF center or ally us via WhatsApp for more information. We can help you.