Kagee Ashraf
Department of Psychology, Stellenbosch University, South Africa.
Afr J Disabil. 2014 Apr 23;3(1):100. doi: 10.4102/ajod.v3i1.100. eCollection 2014.
Anecdotal data suggest that some South Africans living with HIV who receive disability grants from the state deliberately default on their antiretroviral medication in an attempt to lower their CD4 count to remain eligible for grants. No actual empirical data however exist to show that disability grants act as such perverse incentives and are a valid reason for non-adherence. This article examines some of the complexities of antiretroviral adherence in the context of a resource-constrained environment. The multitude of structural barriers, including sometimes difficult patient-doctor conversations about the renewal of disability grants, shape patients' experiences of the clinic environment and influence their adherence to care.
轶事数据表明,一些领取国家残疾补助金的南非艾滋病毒感染者故意不服用抗逆转录病毒药物,试图降低他们的CD4细胞计数,以便继续符合领取补助金的条件。然而,目前尚无实际的经验数据表明残疾补助金会产生这种不良激励,也没有证据表明这是不坚持治疗的合理理由。本文探讨了在资源有限的环境下抗逆转录病毒治疗依从性的一些复杂性。众多的结构性障碍,包括有时关于残疾补助金续期的医患沟通困难,塑造了患者对诊所环境的体验,并影响他们对治疗的依从性。