Représentations de l’échec thérapeutique des traitements ARV chez les patients et les professionnels de santé à Dakar

Abstract

The aim of this qualitative study was to describe and analyze representations of therapeutic failure and the medical and social responses proposed by health care professionals and patients receiving follow-up in the ANRS cohort 1215 in Senegal from 1999 to 2010. Patients' medical histories show that therapeutic failures are related to complex multifactorial situations, resulting from factors attributable to patients (adherence failure related to various psychosocial problems) but also to health care structures (organization of the health system, training for health care professionals and availability of biological exams and appropriate drugs). Both patients and health care staff recognize these causes. The incidence of the onset of therapeutic failures should be regarded as an indicator of the quality of care provided. Further thought should be given to how well health care systems function when changes occur in these rates.