Home > The lived experience of adherence to HIV medication in the context of homelessness and addiction.

Maloney, Eavanna (2023) The lived experience of adherence to HIV medication in the context of homelessness and addiction. MSc thesis, Dublin City University.

External website: https://doras.dcu.ie/27977/


At the end of 2020, The Global Health Observatory estimated that globally there are 37.7 million people living with HIV (WHO, 2022). In Ireland, in 2021 over 6,000 people were estimated to be living with HIV, however this figure has already increased in 2022 with 293 notified cases of HIV in the first six months of 2022, compared to 145 for the same period of 2021 (Health Protection Surveillance Centre 2022). The HPSC 2021 statistics reveal that in 2% of HIV cases, intravenous drug use behaviour was the source of transmission. Research studies and health strategies emphasize the importance of adherence to HAART (Highly Active Antiretroviral Therapy) to avoid viral replication and personal/public health consequences. However, it is evident that addiction and homelessness can contribute to non-adherence to medical and pharmacological treatment for a range of diseases. Explanations have been put forward in the research including, side effects, stigma/shame, lack of structure/routine, cognitive impairment caused by drug use, lack of motivation/self-worth, lack of facilities to store and take medication. Adherence to HIV treatment for people who are homeless and in addiction, is further complicated by the required drug regimen which can be complex and difficult to tolerate. This study explores the lived experience of adhering to HIV medication in the context of drug addiction and homelessness, using a qualitative research approach, involving interviews with six people experiencing homelessness and addiction and who are prescribed HIV medication. Individual participant narratives are gathered and analyzed using Riesman’s (2008) narrative analysis framework which enables a deep exploration of the stories people tell about their lived experiences. The study findings illuminate how HIV, addiction and homelessness impact on adherence to HAART particularly in relation to diagnosis experiences, stigma and shame as well as the challenges of managing treatment in the context of homelessness and addiction. It is anticipated that the findings, discussion and potential recommendations from the study will contribute to improved understanding of the needs of this population and more sensitive person centred approaches.

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