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

April 11, 2014 by Andrea Lauder, University of Alberta
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

HIV no barrier to getting liver transplant, study finds

May 17, 2013
(HealthDay)—Liver transplants to treat a common type of liver cancer are a viable option for people infected with HIV, according to new research.

HIV treatment while incarcerated helped prisoners achieve viral suppression

March 31, 2014
Treating inmates for the human immunodeficiency virus (HIV) while they were incarcerated in Connecticut helped a majority of them achieve viral suppression by the time they were released.

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 ...

Hepatitis C remains major problem for HIV patients despite antiretroviral therapy

March 17, 2014
A new study led by researchers at the Perelman School of Medicine at the University of Pennsylvania has found that the risk of hepatitis C-associated serious liver disease persists in HIV patients otherwise benefitting from ...

Rilpivirine combination product in pretreated HIV-1 patients: Added benefit not proven

April 7, 2014
The German Institute for Quality and Efficiency in Health Care (IQWiG) reassessed the antiviral drug combination rilpivirine/emtricitabine/tenofovir. In early 2012, the combination was approved for the treatment of adults ...

Recommended for you

War in Ukraine has escalated HIV spread in the country: study

January 15, 2018
Conflict in Ukraine has increased the risk of HIV outbreaks throughout the country as displaced HIV-infected people move from war-affected regions to areas with higher risk of transmission, according to analysis by scientists.

Researchers offer new model for uncovering true HIV mortality rates in Zambia

January 12, 2018
A new study that seeks to better ascertain HIV mortality rates in Zambia could provide a model for improved national and regional surveillance approaches, and ultimately, more effective HIV treatment strategies.

New drug capsule may allow weekly HIV treatment

January 9, 2018
Researchers at MIT and Brigham and Women's Hospital have developed a capsule that can deliver a week's worth of HIV drugs in a single dose. This advance could make it much easier for patients to adhere to the strict schedule ...

New long-acting, less-toxic HIV drug suppresses virus in humanized mice

January 8, 2018
A team of Yale researchers tested a new chemical compound that suppresses HIV, protects immune cells, and remains effective for weeks with a single dose. In animal experiments, the compound proved to be a promising new candidate ...

Usage remains low for pill that can prevent HIV infection

January 8, 2018
From gritty neighborhoods in New York and Los Angeles to clinics in Kenya and Brazil, health workers are trying to popularize a pill that has proven highly effective in preventing HIV but which—in their view—remains woefully ...

Researchers find clues to AIDS resistance in sooty mangabey genome

January 3, 2018
Peaceful co-existence, rather than war: that's how sooty mangabeys, a monkey species found in West Africa, handle infection by SIV, a relative of HIV, and avoid developing AIDS-like disease.


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.