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Home / American Journal of Health Behavior, Volume 46, Number 2

Open Access Predictors of Self-repackaging of Antiretroviral Therapy in Northern Tanzania

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Objectives: In this study, we explored determinants of "researcher-observed" patient-initiated antiretroviral therapy (ART) repackaging practices among people living with HIV (PLHIV) in Northern Tanzania. Methods: We used a quasi-experimental design to describe the prevalence of ART self- repackaging; we conducted face-to-face surveys to determine factors associated with ART self- repackaging practices. Data collection sites included the Kilimanjaro Christian Medical Centre and the Mawenzi Referral Hospital. We used study-specific numerical identifiers assigned to ARTs packaging to determine self-repackaging behavior. Self-repackaging was defined as a binary variable where participants who discarded antiretroviral drugs packaging in at least 2 clinic visits were classified as self- repackagers. We used multivariable logistic regression to assess the determinants of patient-initiated repackaging practices. Results: Among 590 study participants, 57.6% self-repackaged based on researcher observation and 55.6% self-repackaged based on patient report. Researcher-observed self- repackaging was associated with gender (AOR = 1.590; 95% CI: 1.011, 2.502), employment status (AOR = 0.475: 95% CI; 0.239, 0.942), and study site (AOR = 0.218; 95% CI: 0.134, 0.355). Conclusions: A substantial proportion of patients self-repackage their ARTs for various reasons. Health system interventions should focus on addressing the attributes of repackaging among men and unemployed patients.

Keywords: ANTIRETROVIRAL DRUGS; RESEARCHER-OBSERVED; SELF-REPACKAGING

Document Type: Research Article

Affiliations: 1: Seleman K. Semvua, Kilimanjaro Christian Medical University College, Moshi, Tanzania;, Email: [email protected] 2: Christine Yaeree Kim, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States, and Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States 3: Charles Muiruri, Kilimanjaro Christian Medical University College, Moshi, Tanzania, and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States, and Duke Global Health Institute, Duke University, Durham, NC, United States 4: Timothy Antipas Peter, Kilimanjaro Christian Medical University College, Moshi, Tanzania 5: Blandina T. Mmbaga, Kilimanjaro Christian Medical University College, Moshi, Tanzania, and Duke Global Health Institute, Duke University, Durham, NC, United States 6: John A. Bartlett, Kilimanjaro Christian Medical University College, Moshi, Tanzania, and Duke Global Health Institute, Duke University, Durham, NC, United States 7: Leah L. Zullig, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States, and Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States 8: Shelley A. Jazowski, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States, and Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States 9: Brandon A. Knettel, Duke Global Health Institute, Duke University, Durham, NC, United States, and School of Nursing, Duke University, Durham, NC, United States 10: Francis P. Karia, Kilimanjaro Christian Medical University College, Moshi, Tanzania, and Duke Office of Clinical Research. Duke University School of Medicine, Durham, NC, United States 11: Habib O. Ramadhani, Kilimanjaro Christian Medical University College, Moshi, Tanzania, and Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States

Publication date: 01 April 2022

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

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