Barriers and facilitators to patients' adherence to antiretroviral treatment in Zambia: a qualitative study

Abstract

Patients' adherence to antiretroviral therapy (ART) is important for effective medical treatment of HIV/AIDS. We conducted a qualitative interview study in the Copperbelt Province of Zambia in 2006. The aim of the study was to explore patients' and health care professionals' perceived barriers and facilitators to patients' adherence to ART. Based on data from individual interviews and focus group interviews with a total of 60 patients and 12 health care professionals, we identified barriers and facilitators related to patients' beliefs and behaviours, the health service, and socio-economic and cultural factors. Among the barriers we identified were lack of communication and information about ART, inadequate time during consultations, lack of follow-up and counselling, forgetfulness, stigma, discrimination and disclosure of HIV status, lack of confidentiality in the treatment centres, and lack of nutritional support.Feeling better, prospects of living longer, family support, information about ART, support for income-generating activities, disclosure of HIV status, prayers and transport support were among the facilitators. Our study suggests that several issues need to be considered when providing ART. Further research is needed to study interactions between patients and their health care providers. Our findings can inform interventions to improve adherence to ART.

Universal test and treat and the HIV epidemic in rural South Africa: a phase 4, open-label, community cluster randomised trial

“…Patients who have missed doses have often cited not having food at home as a reason for missing doses because of the prevailing perception that it is bad to take their drugs on an empty stomach. This anecdotal observation has been confirmed in formal qualitative studies [31,32] and should be discussed when preparing patients for ART initiation.…”

The Enabling Effect of Food Assistance in Improving Adherence and/or Treatment Completion for Antiretroviral Therapy and Tuberculosis Treatment: A Literature Review

“…Food insecurity is one of the multiple barriers that individuals face in initiating and adhering to long-term medical therapies such as ART and DOTS, especially in resourcelimited settings [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Other patient-related barriers include the complexity of the medication regimen [18], emotional distress [7], illness costs to households [19], stigma [20], health beliefs and poverty [4], limited knowledge of the disease [21], difficulty remembering [22], intentional non-adherence due to adverse drug reactions [23] and harmful use of alcohol [24].…”

Levels and Predictors of Food Insecurity among HIV Positive Adult Patients Taking Highly Active Anti-Retroviral Therapy at Arba Minch General Hospital, Southern Ethiopia, 2016

“…More than 35 million people are living with HIV and most cases have been reported in low and middle-income countries, particularly in Sub Saharan Africa (SSA) [21]. Study conducted in Canadia among HIV-infected individuals receiving HAART showed that 71% were food insecure [22]. Study conducted in Democratic Republic of Congo, 57% and in Namibia 92% were food insecure respectively [23,24].…”