Chabikuli, Nzapfurundi O.Datonye, D.O.Nachega, J.Ansong, D.2010-09-132010-09-132010Chabikuli, NO, Datonye, DO, Nachega, J & Ansong, D 2010, 'Adherence to antiretroviral therapy, virologic failure and workload at the Rustenburg provincial hospital', South African Family Practice, vol. 52, no. 4, pp. 350-355. [www.safpj.co.za]1726-426Xhttp://hdl.handle.net/2263/14831BACKGROUND: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remains the most important potentially alterable factor that determines treatment outcomes. METHODS: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included a randomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results. RESULTS: Only 71% of patients had an adherence > 95%. Poor adherence was related to changes in daily routines (being away from home [21%] and busy with other things [17%]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7%) had virologic failure than did employed patients (40%) (p = < 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio, and the proportion of patients lost to follow-up doubled in the preceding four years. CONCLUSION: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered.en© SAAFPAdherenceARTHIV humanHuman resourceSouth Africa (SA)Highly active antiretroviral therapy (HAART)Article