Researcher studies what makes people with HIV successful at sticking with antiretroviral treatment

April 11, 2014 by Andrea Lauder
Credit: Michael Lavoie Photography

At the end of 2011, an estimated 34 million people worldwide were living with HIV/AIDS. In Alberta, the total was 1,532. Thanks to scientific improvements in antiretroviral therapy, many of these Albertans are living long and full lives. The key to living longer with HIV is sticking with the antiretroviral therapy prescribed.

Megan Lefebvre, a PhD candidate with the School of Public Health, is intrigued by the factors that make people successful at adhering to . Working with the Northern Alberta HIV Program, Lefebvre noted that patients who identified themselves as having chaotic lives—those experiencing unstable housing, substance use and incarceration—still managed to adhere to their antiretroviral therapy.

"A lot of studies had been directed toward the barriers and the failures of HIV adherence," says Lefebvre. "Nobody had asked patients why they were successful with adhering, or how they'd been doing it. That's what I wanted to learn more about."

Using a research method called focused ethnography, Lefebvre purposely chose and interviewed 14 HIV-positive patients receiving care at the Northern Alberta program. These patients were very knowledgeable about their health and their , and could share details about their experiences as patients.

A measure of control in the midst of chaos

Lefebvre learned that, although the patients had chaotic lives, the one area they felt they could control was taking their antiretroviral medication.

"When I asked them about their day from start to finish, they were all motivated to take their pills as part of their routine," she says. "When I asked them why they took their pill, they stated, 'Because I don't want to die.'"

She noticed that patients appeared to compartmentalize the chaos in their lives, but taking their antiretroviral medication signified control over one thing in the midst of chaos. Lefebvre noted that this small measure of control enabled patients to take other positive steps in their lives.

For instance, one interviewee indicated that the benefits of taking his medication included getting positive feedback from the health-care team, feeling better and reconnecting with family.

The most important outcome of this research for Lefebvre was the ability to share the information generated by the patients in her study with other HIV patients. Six patients participated in a video that is being used at HIV Edmonton and shown by the video participants themselves—the peer educators—to other HIV-positive individuals. The video and peer educators have created a space for people living with HIV to have conversations about being HIV-positive and about taking their medications.

Lefebvre would like to continue this project and follow up with HIV-positive patients to see whether their adherence behaviour changes. She also envisions using the video and working with clinicians to create more opportunities for other HIV-positive to talk about .

"I've learned a lot from the participants, and I've learned the value of partnering with communities to conduct research," says Lefebvre. "Working together, we've created valuable tools that will help translate research knowledge into practice and support marginalized populations."

Explore further: HIV no barrier to getting liver transplant, study finds

Related Stories

The health benefits of texting

March 13, 2014

Communication between physicians and other health care providers and their patients may be taking on an entirely new dimension through text messaging, according to David Finitsis, a Ph.D. candidate in clinical psychology ...

Dealing with HIV as a chronic disease in Africa

March 31, 2014

Since 2004, the number of patients on antiretroviral drugs in Sub-Saharan Africa has increased 24 times, to 6.9 million*. HIV has become a chronic disease. A lifelong strict adherence to treatment is necessary. Health systems ...

Recommended for you

Vitamin D status related to immune response to HIV-1

June 15, 2015

Vitamin D plays an important part in the human immune response and deficiency can leave individuals less able to fight infections like HIV-1. Now an international team of researchers has found that high-dose vitamin D supplementation ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.