an Eldis Resource
The role of parents and family members in ART treatment adherence: evidence from Thailand
How parents can help with treatment support for relatives with HIV/AIDS
Authors:
J. Knodel; J. Kespichayawattana; C. Saengtienchai; S. Wiwatwanich
Publisher:
Impact of the AIDS Epidemic on Older Persons, 2009
High levels of treatment adherence are crucial for the success of expanding anti-retroviral therapy (ART) treatment programmes for persons with HIV/AIDS (PHA). Although family members are sometimes mentioned in the context of treatment support programmess, they receive far less attention than peers. In particular, parents are almost never specifically cited. Yet parents are highly motivated to ensure the health of their adult children and often live with or near their adult child on ART in many settings with significant AIDS epidemics.
The neglect of parents’ potential to assist is probably related to their older ages. Health professionals may incorrectly assume that older persons, who in poorer countries typically have low levels of formal education, are incapable of sufficiently understanding ART to provide useful assistance. However, a recent study in Cambodia, provides evidence to the contrary.
This report examines the extent that family members, especially parents, are involved in assisting adherence in Thailand based on results from questionnaires from 912 adult ART recipients in 18 sites throughout the country.
Results indicate that:
- most ART patients live with family members and over 60% live with or in the same locality as a parent
- family members, including parents, commonly assist ART patients to remember to take their medications, particularly if they are in the same household
- parents often remind adult sons and daughters to go for resupplies, and also bring or accompany them to their appointments
The authors argue that their findings underscore the need to incorporate close family members, including parents, more explicitly into programs intended to augment adherence and to facilitate their effectiveness as long-term adherence partners by providing them with adequate information, training and resources. Peers from community based PHA groups can be a particularly valuable and appropriate asset in this regards. These findings are relevant not only for Thailand but for the many settings where ART recipients are similarly closely linked to other family members through living and caregiving arrangements.
