Original Research

Prevention is better than cure – the art of avoiding non-adherence to antiretroviral treatment

Leith Kwaan, Gurpreet Kindra, Lulama Mdutyana, Anna Coutsoudis
Southern African Journal of HIV Medicine | Vol 11, No 2 | a223 | DOI: https://doi.org/10.4102/sajhivmed.v11i2.223 | © 2010 Leith Kwaan, Gurpreet Kindra, Lulama Mdutyana, Anna Coutsoudis | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2010 | Published: 04 November 2010

About the author(s)

Leith Kwaan, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa
Gurpreet Kindra, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa
Lulama Mdutyana, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa
Anna Coutsoudis, Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa

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Abstract

The much-used phrase ‘prevention is better than cure’ is applicable to many circumstances, including human immunodeficiency virus (HIV) infection. In recent years suggestions have been made for a move towards treatment strategies that emphasise prevention of foreseeable adherence problems on a patient-by-patient basis, through focused patient preparation before commencing antiretroviral therapy (ART). This is well elucidated in a statement made in 2004 by Coetzee et al.:1 ‘As it is difficult to ascertain robust predictors of adherence, there has been a move to concentrate on patient preparation before the initiation of ART rather than the use of non-clinical predictors of adherence or selection criteria. A paradigm focused on preparation rather than selection is better suited to the aggressive targets for the scaling up of ART in countries with large epidemics (such as in South Africa), where the view of ART as a very expensive rationed intervention is rapidly changing.’

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Crossref Citations

1. Systemic delays in the initiation of antiretroviral therapy during pregnancy do not improve outcomes of HIV-positive mothers: a cohort study
Landon Myer, Rose Zulliger, Linda-Gail Bekker, Elaine Abrams
BMC Pregnancy and Childbirth  vol: 12  issue: 1  year: 2012  
doi: 10.1186/1471-2393-12-94