Understanding Patterns of Social Support and Their Relationship to an ART Adherence Intervention Among Adults in Rural Southwestern Uganda
Date
2006-09-26Author
Atukunda, Esther Cathyln
Musiimenta, Angella
Musinguzi, Nicholas
Metadata
Show full item recordAbstract
Abstract SMS is a widely used technology globally and
may also improve ART adherence, yet SMS notifications to
social supporters following real-time detection of missed
doses showed no clear benefit in a recent pilot trial. We
examine the demographic and social-cultural dynamics that
may explain this finding. In the trial, 63 HIV-positive
individuals initiating ART received a real-time adherence
monitor and were randomized to two types of SMS
reminder interventions versus a control (no SMS). SMS
notifications were also sent to 45 patient-identified social
supporters for sustained adherence lapses. Like participants, social supporters were interviewed at enrollment,
following their matched participant’s adherence lapse and
at exit. Social supporters with regular income (RR = 0.27,
P = 0.001) were significantly associated with fewer
adherence lapses. Instrumental support was associated with
fewer adherence lapses only among social supporters who
were food secure (RR = 0.58, P = 0.003). Qualitative
interview data revealed diverse and complex economic and
relationship dynamics, affecting social support. Resource
availability in emotionally positive relationships seemingly
facilitated helpful support, while limited resources prevented active provision of support for many. Effective
social support appeared subject to social supporters’ food
security, economic stability and a well-functioning social
network dependent on trust and supportive disclosure.
Collections
- Research articles [62]