Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - November 20, 2003
High cost: Financial constraints were reported to be the most significant barrier to anti-retroviral adherence in patients living with HIV and Aids in Botswana prior to the introduction of free treatment. Reports say that though 54% of the patients said they took their drugs as prescribed, if cost were not a barrier 74% would have been adherent.
Treatment adherence has been closely correlated with viral suppression, while non-adherence has contributed to progression to Aids, the development of multi-drug resistance and death.
The study highlights several problems that will affect decision-making by governments, donors and public health officials throughout the developing world as anti-retroviral treatment is introduced. Decisions about the balance of free treatment provision and cost recovery will need to be taken in the light of evidence suggesting that the cost of treatment is the biggest single determinant of non-adherence in all studies carried out in Africa
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