An investigation of the determinants of adherence to highly active anti-retroviral therapy in Aboriginal men in the Downtown Eastside of Vancouver.

The eradication of HIV is not yet possible therefore, persons undergoing treatment must take highly active anti-retroviral therapy (HAART) regularly. In British Columbia, anti-retrovirals are distributed at no cost but the HIV-related annual mortality rate stands at 9 percent. The purpose of this study was to investigate the determinants of adherence to HAART in Aboriginal men in the Downtown Eastside of Vancouver. A Vancouver School of Doing Phenomenology method was chosen for the study. Five main determinants of adherence emerged from the data. The presence of patient factors like depression, a history of trauma/ residential school attendance, inter-personal factors like stigma and discrimination, absence of support structures, medication-related factors like a complex treatment regimen reduces adherence. Patients may overcome some of the barriers by receiving better health education about the need for adherence, professional and lay support, and being encourage to follow their traditional ways of living. --P. ii.