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Title Barriers to HIV Treatment Adherence: A Qualitative Study of Discrepancies Between Perceptions of Patients and Health Providers in Tanzania and Uganda.
Full text https://escholarship.org/uc/item/62f6g612
Date 2019
Author(s) Moucheraud, Corrina; Stern, Amy F; Ahearn, Canice; Ismail, Anisa; Nsubuga-Nyombi, Tamara; Ngonyani, Monica M; Mvungi, Jane; Ssensamba, Jude
Abstract Previous qualitative studies about antiretroviral therapy (ART) adherence have largely focused on patient experiences. Less is known about the perspective of health care providers-particularly in low-income countries-who serve as gatekeepers and influencers of patients' HIV care experiences. This study explored patients' and providers' perceptions of important ART adherence determinants. Interviews were conducted at HIV treatment sites in Tanzania and Uganda, with adult patients on ART (n = 148), and with health care providers (n = 49). Patients were asked about their experiences with ART adherence, and providers were asked about their perceptions of what adherence challenges are faced by their patients. All interviews were conducted in local languages; transcripts were translated into English and analyzed using a codebook informed by the social ecological model. Themes were examined across and within countries. Adherence-related challenges were frequently reported, but patients and providers did not often agree about the reasons. Many patients cited challenges related to being away from home and therefore away from their pill supply; and, in Uganda, challenges picking up refills (access to care) and related to food sufficiency/diet. Providers also identified these access to care barriers, but otherwise focused on different key determinants (e.g., they rarely mentioned food/diet); instead, providers were more likely to mention alcohol/alcoholism, stigma, and lack of understanding about the importance of adhering. These findings suggest areas of opportunity for future research and for improving clinical care by aligning perceptions of adherence challenges, to deliver better-informed and useful ART counseling and support.
Subject(s) Humans; HIV Infections; Anti-Retroviral Agents; Attitude of Health Personnel; Attitude to Health; Health Knowledge; Attitudes; Practice; Motivation; Perception; Counseling; Qualitative Research; Social Support; Poverty; Adult; Health Personnel; Tanzania; Uganda; Female; Male; Interviews as Topic; Medication Adherence; Social Stigma; antiretroviral therapy; health behavior; medication adherence; qualitative research; Behavioral and Social Science; HIV/AIDS; Clinical Research; Prevention; Health Services; 8.1 Organisation and delivery of services; Health and social care services research; 7.1 Individual care needs; Management of diseases and conditions; Infection; Good Health and Well Being; Public Health and Health Services; Virology
Coverage 406 - 413
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source AIDS patient care and STDs, vol 33, iss 9
Rights public
Identifier qt62f6g612
Repository Berkeley - University of California
Added to C-A: 2022-09-19;09:08:03