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Common problems with antiretroviral therapy among three Swedish groups of HIV infected individuals

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Abstract

Objective

The main objective of this study was to identify and compare the common problems and difficulties associated with combination antiretroviral therapy (CART) as experienced by three major groups of HIV infected individuals (homo- or bisexuals, former injecting drug users and origins of Sub-Saharan Africa) in Sweden.

Methods

Based on the results from in-depth interviews with 15 representatives from the three major groups, a questionnaire was designed for use in a problem detection study (PDS). The study was conducted with 195 HIV-positive patients residing in the major cities of Sweden.

Results

The overall response rate was 79%. The problems identified in all three groups were negative attitudes from the public, worries about disease progression or therapy failure, medication or drug-related problems and problems in connection to pharmacy visits. A specific problem in the homo- or bisexual group was drug-related problems such as adverse effects, drug interactions and pill burden. For former injecting drug users, the specific problem was disease-related conflicts with relatives and the problem of coping with the social and psychological burden caused by the HIV infection. The African group termed the risk of exposing their medication at the pharmacy as a specific problem, as this could reveal their HIV status.

Conclusions

Our findings regarding problems with CART in three patient groups in Sweden may be of use to tailor pharmacy care to HIV infected individuals.

General strategies to improve adherence need to be complemented with approaches that will address the specific needs for the different patient groups affected by HIV. Further studies on group-specific interventions that promote concordance and adherence to CART will be necessary to minimize therapy failure and viral resistance.

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Acknowledgements

The authors thank Sveriges Farmaceutiska Sällskap for awarding a scholarship to the project and Pharmacist Lena Lagerholm for assistance. Special thanks to the staff of RFHP (the Swedish Group for HIV Positives), CONVICTUS (former injecting drug users) and OASEN (group for origins of Sub-Saharan Africa) for their invaluable support in collecting the study data. Thanks to the Pharmacist Mr and Mrs Mgbemena for reading the final stage of the manuscript.

Funding

This work was funded by the National Corporation of Swedish Pharmacies (Apoteket AB) and the Swedish Foundation for Strategic Research.

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Authors and Affiliations

  1. Apoteket Källan, Box 64, 14501, Norsborg, Sweden

    Amadou Jallow

  2. Apoteket AB, 131 88, Stockholm, Sweden

    Sofia Kälvemark Sporrong

  3. Department of Medicine, Center for Infectious Medicine, Karolinska Institute, Karolinska University Hospital, 141 86, Huddinge, Stockholm, Sweden

    Lilian Walther-Jallow

  4. Hospital Pharmacy, Karolinska University Hospital, 141 86, Huddinge, Stockholm, Sweden

    Peter M. Persson

  5. Unit of Infectious Diseases, Karolinska University Hospital, 141 86, Huddinge, Stockholm, Sweden

    Urban Hellgren

  6. Department of Health and Medical Services, The National Board of Health and Welfare, 106 30, Stockholm, Sweden

    Örjan Ericsson

Authors
  1. Amadou Jallow
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  2. Sofia Kälvemark Sporrong
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  3. Lilian Walther-Jallow
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  4. Peter M. Persson
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  5. Urban Hellgren
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  6. Örjan Ericsson
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Correspondence to Amadou Jallow.

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Jallow, A., Sporrong, S.K., Walther-Jallow, L. et al. Common problems with antiretroviral therapy among three Swedish groups of HIV infected individuals. Pharm World Sci 29, 422–429 (2007). https://doi.org/10.1007/s11096-007-9092-4

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  • DOI: https://doi.org/10.1007/s11096-007-9092-4

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