Enhancing adherence to antiretroviral treatment : the potential role of church leaders in Vulindlela, KwaZulu-Natal.

Abstract

South Africa is currently managing the world‟s biggest antiretroviral treatment (ART) programme since a large section of its population is using ART daily. ART requires a meticulous adherence plan as this medication is a lifelong treatment. Currently there is an ongoing outcry about poor adherence to ART which leads to drug resistance. There are many factors that predict poor adherence to ART. These include the social structural system of socioeconomic formation, individual behaviours and medical conditions. Investigating the role of the church in enhancing adherence to ART is, therefore, important. Parry‟s (2008) framework of an “HIV competent church” guided this study to analyze the engagement of Vulindlela church leaders in programmes that are meant to improve ART adherence. The findings of this analysis revealed that some Vulindlela church leaders had adequate competence to initiate church-based ART adherence programmes. This included a willingness to act against structural factors that facilitate treatment resistance. However, there were others who were unable to get involved due to particular theological traditions. Findings also revealed that these Vulindlela church leaders had little medical knowledge about ART and the importance of adherence. The field work process also revealed that, generally, the Vulindlela church leaders were uncomfortable to talk about sex and sexuality in the public realm. These findings suggest that more systematic theological training needs to be introduced that will assist church leaders in dealing with the HIV epidemic in a more positive theological way. This includes the need to tackle the subject of sexuality in a sensitive way taking into account cultural taboos and providing helpful theological insights. Through this investigation, lessons have been learnt which can assist in the future engagement of church leaders in enhancing ART adherence