Acceptability of obtaining hair samples for assessing antiretroviral therapy (ART) exposure amongst alcohol drinking ART recipients in Tshwane, South Africa

• Published in: AIDS care Vol. 30; no. 12; pp. 1498 - 1501
• Main Authors: Kekwaletswe, C.T., Nkosi, S., Kitleli, N.B., Myers, B., Shuper, P., Parry, C.D.H., Morojele, N.K.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 02.12.2018; Taylor & Francis Ltd
• Subjects: Acceptability; Adherence; Adhesion; Adult; AIDS/HIV; Alcohol; alcohol consumption; Alcohol Drinking - adverse effects; Alcohol use; Alcohols; Anti-HIV Agents - therapeutic use; Anti-Retroviral Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; ART exposure; Art therapy; Blood tests; Content analysis; Data processing; Drinking behavior; Drug therapy; Exposure; Female; Focus Groups; Hair; hair samples; Health care; Health status; HIV Infections - drug therapy; HIV Infections - psychology; Humans; Male; Medical personnel; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Middle Aged; Mixed gender; Patient Acceptance of Health Care; Quality of Life; South Africa; Therapy; Vietnam; Witchcraft; South Africa; Vietnam; ART exposure; hair samples; alcohol consumption; acceptability
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2018.1476662

To achieve the maximal therapeutic benefits of antiretroviral therapy (ART), high adherence is required. In South Africa, ART recipients are usually counselled by their health care providers to stop drinking alcohol, as heavy alcohol use compromises ART adherence. Patients who continue drinking alcohol tend to hide their alcohol-related adherence challenges from their health care providers. Objective measures of ART adherence/exposure may help to better identify drinkers who could benefit from ART adherence enhancement interventions. To evaluate the acceptability of collecting hair samples to objectively assess ART exposure among alcohol drinkers, we conducted four mixed-gender focus group discussions (FGDs) with alcohol drinking ART recipients at two ART sites in Tshwane, South Africa. Data were analysed using content analysis. ART recipients found hair sample testing for ART exposure to be novel and therefore expected that some ART recipients would initially be hesitant to provide a sample. Participants thought that the acceptability of hair sample collection could be enhanced by providing a full explanation of how the hair sample would be obtained and what the testing would entail. Participants also viewed hair sample testing as a viable and desirable alternative to blood sample testing for ART exposure. Some worries about the possible use of hair samples for witchcraft and the symbolic nature of hair were brought up, but these were not seen as insurmountable concerns. In conclusion, hair sample testing is a potentially acceptable method of assessing ART exposure amongst ART recipients who drink alcohol.