The Development Model of (ARV) Service to Support Drug Adherence for HIV/AIDS People (PHA) in North-eastern part, Thailand

Abstract

This study was aimed to develop the model of ARV service to support drug adherence for PHA in North-eastern part, in the responsible area of the office of disease prevention and control region 10^th Ubon Ratchathani. Four steps of model development were 1) theoretical base of model building up, 2) collecting the data and the service obstacle for approve the model, 3) model development by stake holder participation, and 4) implementation and evaluation the model. The study area was ARV clinic in 5 provincial hospitals. Target group were the service provider and the core group of PHA who working in ARV clinic and those who working on AIDS at provincial level: 30 people, PHA who provide the ARV service, 330 people and the representative of public health form provincial health office, 5 people. Data was collected by interview belong to the research tools. Quantitative data was analyzed by MRA and qualitative data was by content analysis.

The most sample were female (58.7%), CD >200 (86.4%), Viral load <50 copy (94.3%), no opportunity infectious (84.9%), average year of taking ARV drug Mean 7.6 years, member of PHA network (53.3%), and provided budget support from the government (56%). The obstacle the implementation of service model to support ARV adherence for PHA were PHA misunderstand of treatment, the delay service due to patient’s right for ARV treatment, lacking of preparedness of PHA for ARV treatment especially for the HIV new case under the any CD4 policy of Department of Disease Control, and the PHA data was reveal during referred from the hospital to the community. The model of ARV service to support drug adherence for PHA in ARV clinic was the service comprise 4 components; the service that was coverage with the dimensions of physical mental and societal, continuously service from the hospital to the family and community, service by the integrated team of professional of public health, and service by one stop service. The process of service was divided in 3 steps; the preparedness of the PHA, the ARV service within the clinic, and the referral system to serve the continuous service from the ARV clinic to the family and community. The provider was the public health personnel and the PHA core group who had direct experience from ARV treatment and PHA specific group: MSM and youth group.