Objective:
highlight the socioeconomic and environmental determining factors
of long-term observance to antiretroviral treatments in developing
countries.
Method: The regularity of antiretroviral prescriptions renewal
at the central pharmacy of the Yaounde Central Hospital (Cameroon)
was measured through analysing the medical and pharmaceutical
files of 230 patients over the 21 month start-up period. 99 patients
were also interviewed during the last six months. The determining
factors were analysed according to various socio-economic criteria,
linked with the longitudinal study of treatment observance.
Results: The huge price decrease of HIV treatments during the
start-up period was conducive to an increase in new treatments
by a factor 5.76. In this context of an exploding demand, the
paper shows that observance is firstly dependent on quality information
about illness and treatment protocols, while longer term adherence
is partly dependent on financial capability, and includes the
strong influence of living conditions and behaviours.
Conclusion: The paper recommends the introduction of free treatment
as an objective in national sector policies and the organisation
of a long term following-up of patients. In the African context
of poverty and actual decentralisation of healthcare, the question
of the availability of human resources is profoundly enhanced.
