Experiences of Thai-Muslim patients regarding inconsistent antiretroviral therapy adherence: An exploratory descriptive qualitative study
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Keywords

medication adherence
antiretroviral therapy
health personnel
HIV/AIDS
Islam

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Perngmark, P., Sahawiriyasin, O., & Holroyd, E. (2023). Experiences of Thai-Muslim patients regarding inconsistent antiretroviral therapy adherence: An exploratory descriptive qualitative study. Belitung Nursing Journal, 9(3), 253–261. https://doi.org/10.33546/bnj.2426
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Accepted for publication: 2023-04-03
Peer reviewed: Yes

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Abstract

Background: Antiretroviral therapy (ART) has played a crucial role in saving countless lives of patients with HIV/AIDS across the world. However, despite its effectiveness, ART adherence still falls short globally, and non-adherence remains the primary cause of treatment failure. In the rural areas of southern Thailand, where the population is predominantly conservative Muslims, there has been an observed increase in ART non-adherence.

Objective: This study aimed to explore experiences of inconsistent ART adherence among Thai-Muslim patients with HIV/AIDS (PWHAs) in southern Thailand. In addition, the perspectives of healthcare providers were also sought.

Methods: Data were collected by conducting semi-structured in-depth interviews with ten Thai-Muslim PWHAs and five healthcare providers at a Voluntary Counseling-and-Testing Clinic. A content analysis approach was utilized to analyze the data.

Results: Inconsistent ART adherence was reported. Religion/spiritual imperatives, forgetfulness, inadequate knowledge (of drug side effects and drug regime), misunderstandings (about being symptom-free and feeling well), boredom from long-term drug-taking regimes, as well as poor transportation and lack of family support (arising from non-disclosure of one’s HIV-serostatus due to HIV stigma) were emergent themes derived from the interviews with Thai-Muslim PWHAs. The healthcare providers’ interview data revealed their need for the integration of Islamic beliefs to provide better care.

Conclusion: It is essential for healthcare teams to work collaboratively with patients’ religious beliefs to enhance ART adherence. Clinical nurses can contribute to the promotion of HIV-care services by integrating Islamic beliefs and Muslim culture into their practice, thus increasing patients' knowledge and motivation for ART adherence. This could entail utilizing Islamic prayer rituals as drug reminders, elaborating on Islamic moral beliefs concerning sickness and healing, and integrating the cultural imperatives of self-care in the Muslim community into ongoing care delivery. Cross-cultural nursing education and specialized training in HIV care should incorporate knowledge about Islamic and Muslim cultural beliefs.

https://doi.org/10.33546/bnj.2426
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Supporting Agencies

This study was partially supported by the Graduate School, Prince of Songkla University, Thailand

Copyright

Copyright (c) 2023 Pajongsil Perngmark, Oatcharaphon Sahawiriyasin, Eleanor Holroyd

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

None.

Acknowledgment

We would like to thank all Muslim patients with HIV/AIDS, clinical nurses, physicians, and pharmacists for their time and for sharing their information in this study. We thank Wantusneam Ali-Deman for assistance in data collection. We appreciate help from the director and staff of the VCT clinic for providing facilities. Lastly, we thank Associate Professor Usanee Pethratachart for assisting in checking the accuracy of the study findings.

Authors’ Contributions

PP and OS conceived the study and designed and analyzed the data. OS collected the data. PP directed study progress. EH assisted in data analysis and contributed to editing the manuscript. PP, OS, and EH wrote and reviewed the manuscript. All authors provided critical thoughts on the paper and read and approved the manuscript.

Data Availability

The datasets generated during and analyzed during the current study are available from the corresponding author upon reasonable request.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


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