Déterminants psychosociaux et observance thérapeutique du traitement antirétroviral : cas des patients suivis dans les centres de prise en charge de la ville de Yaoundé

Abstract

The aim of this thesis is to study the psychosocial dispositions that determine therapeutic adherence to antiretroviral thérapy in people living with HIV/AIDS. Indeed, the behavior of many people with HIV and followed in treatment centers is not always in accordance with medical advice despite the initiatives (free treatment, multiplication of care centers, etc.) companies to promote therapeutic adherence (national commutee for the fight against AIDS, 2014). This raises the question of what determines therapeutic adherence among PLWHA. To better understand these psychosocial dispositions at work in therapeutic adherence, two empirical studies have been carried out. The first qualitative study aimed to identify the psychosocial determinants associated to therapeutic adherence to ARVs in PLWHA. Using an interview guide, data were collected from 7 PLWHA (n=3 men and n=4 women). Content analysis revealed that etiologic system, social representations of ARVs, self-confidence, social support and economic resources determine adherence to antiretroviral therapy in PLWHA. The second quantitative study aimed to study the influence of etiologic system, social representations of ARVs, self-confidence, social support and economic resources on therapeutic adherence to antiretroviral therapy in PLWHA. 340 PLWHA (n= 119 men and n=221 women) selected from reasoned choice sampling were interviewed using a questionnaire. The results showed that etiologic system (r= 0, 96 ; p0, 05 ; F=182, 37 ; p=0,000), social representations of ARVs (r= 0, 74 ; p0, 05 ; F=145, 17 ; p=0,000), self confidence (r= -0,36 ; p0, 05 ; F=64, 16 ; p=0,000), social support (r= 0, 31 ; p0, 05 ; F=14, 67 ; p=0,000), and economic resources (r= 0, 37 ; p0, 05 ; F=33, 97 ; p=0,000) are correlated with therapeutic adherence to antiretroviral therapy in PLWHA. These results are discussed in the light of previous work and theories. The implications of these results for improving adherence to to antiretroviral therapy in PLWHA are also discussed.