Globalization and Health

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Open Access Review

Unplanned antiretroviral treatment interruptions in southern Africa: how should we be managing these?

Nina Veenstra1*, Alan Whiteside1, David Lalloo2 and Andrew Gibbs1

Author Affiliations

1 Health Economics and HIV/AIDS Research Division, Westville Campus, University of KwaZulu-Natal, Durban, South Africa

2 Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK

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Globalization and Health 2010, 6:4 doi:10.1186/1744-8603-6-4

Published: 31 March 2010

Abstract

Adherence to antiretroviral therapy is essential for maximising individual treatment outcomes and preventing the development of drug resistance. It is, however, frequently compromised due to predictable, but adverse, scenarios in the countries most severely affected by HIV/AIDS. This paper looks at lessons from three specific crises in southern Africa: the 2008 floods in Mozambique, the ongoing political and economic crisis in Zimbabwe, and the 2007 public sector strike in South Africa. It considers how these crises impacted on the delivery of antiretroviral therapy and looks at some of the strategies employed to mitigate any adverse effects. Based on this it makes recommendations for keeping patients on treatment and limiting the development of drug resistance where treatment interruptions are inevitable.