Does Antiretroviral Therapy Packaging Matter? Perceptions and Preferences of Antiretroviral Therapy Packaging for People Living with HIV in Northern Tanzania.

dc.contributor.author

Muiruri, Charles

dc.contributor.author

Jazowski, Shelley A

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Semvua, Seleman K

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Karia, Francis P

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Knettel, Brandon A

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Zullig, Leah L

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Ramadhani, Habib O

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Mmbaga, Blandina T

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Bartlett, John A

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Bosworth, Hayden B

dc.date.accessioned

2022-08-01T13:18:58Z

dc.date.available

2022-08-01T13:18:58Z

dc.date.issued

2020-01-23

dc.date.updated

2022-08-01T13:18:57Z

dc.description.abstract

Introduction

Despite improvements in treatment (eg, reduction in pill intake), antiretroviral therapy (ART) is dispensed in socially inefficient and uneconomical packaging. To make pills less conspicuous and decrease the risk of being stigmatized, people living with HIV (PLWH) often engage in self-repackaging - the practice of transferring ART from original packaging to alternative containers. This behavior has been associated with ART nonadherence and failure to achieve viral load suppression. While much of the literature on ART packaging has centered around medication adherence, patients stated preferences for ART packaging and packaging attributes that influence the observed ART nonadherence are understudied.

Methods

We conducted a qualitative study to elucidate perceptions of ART packaging among PLWH at two large referral hospitals in Northern Tanzania. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed and coded.

Results

Of the 16 participants whose data were used in the final analysis, a majority were between 36 and 55 years of age (Mean 45.5 years SD: 11.1), had primary-level education (n=11, 68.8%), were self-employed (n=9, 56.3%), reported that they had self-repacked ART (n=14, 88%), and were taking ART for more than 6 years (n=11, 68.8%). Participants identified three attributes of ART packaging that increased anticipated HIV stigma and prompted self-repackaging, including visual identification, bulkiness, and the rattling noise produced by ART pill bottles.

Conclusion

Given the drastic reduction in the number of pills required for HIV treatment, there is an opportunity to not only assess the cost-effectiveness of innovative ART packaging but also evaluate the acceptability of such packaging among PLWH in order to address stigma and improve ART adherence.
dc.identifier

238759

dc.identifier.issn

1177-889X

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1177-889X

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https://hdl.handle.net/10161/25535

dc.language

eng

dc.publisher

Informa UK Limited

dc.relation.ispartof

Patient preference and adherence

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10.2147/ppa.s238759

dc.subject

HIV

dc.subject

antiretroviral therapy packaging

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qualitative research

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self-packaging

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stigma

dc.title

Does Antiretroviral Therapy Packaging Matter? Perceptions and Preferences of Antiretroviral Therapy Packaging for People Living with HIV in Northern Tanzania.

dc.type

Journal article

duke.contributor.orcid

Muiruri, Charles|0000-0003-0213-0362

duke.contributor.orcid

Knettel, Brandon A|0000-0003-2986-1579

duke.contributor.orcid

Zullig, Leah L|0000-0002-6638-409X

duke.contributor.orcid

Mmbaga, Blandina T|0000-0002-5550-1916

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

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153

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161

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Duke

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Fuqua School of Business

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School of Medicine

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Medicine, General Internal Medicine

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Medicine, Infectious Diseases

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Duke Cancer Institute

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Global Health Institute

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Published

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14

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