Magister Public Health - MPH / Background: Over the past decade, South Africa has scaled-up its antiretroviral treatment
(ART) programme in an effort to control the HIV epidemic. Interventions to support the rollout
of ART include task shifting ART initiation to nurses at primary health care level and ensuring
HIV adherence counselling at every visit by lay counsellors. Furthermore, community-based
outreach teams work at the community level to follow up on patients and ensure that patients
remain in care and are adhering to ART. Despite all these efforts, poor adherence to ART
remains a pertinent problem. In 2016, the national adherence to ART rate among adult patients
was estimated at 35% compared to 39% in Pule Sefatsa clinic in Mangaung district, Free-state
Province.
Aim: The aim of the study was to explore the factors that influence poor adherence to ART
among patients receiving ART at Pule Sefatsa primary health care clinic in Mangaung district,
South Africa.
Methodology: A descriptive qualitative research approach was used. Two focus group
discussions were conducted with health workers and community caregivers and 16 in-depth
interviews were conducted with ART patients who are in care and those who had defaulted on
their treatment. Audio recorded data obtained from these sources were transcribed verbatim
and prepared for analysis. Thematic analysis was used for data analysis and the results were
classified under various categories.
Findings: Adherence to ART in Pule Sefatsa clinic was found to be influenced by medical
related factors, socio-economic factors, health system factors and individual factors. The
medical-related factor was the side effects of the medication. The socio-economic factors were
stigma and discrimination, lack of family support, poverty and food insecurity. Health system
factors that hindered adherence to ART were medication stock-outs, long waiting times and
poor service delivery. The final group of barriers to ART adherence was related to the
individuals using ART and these include patients forgetting to take treatment and feeling
depressed.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uwc/oai:etd.uwc.ac.za:11394/6703 |
| Date | January 2019 |
| Creators | Jankie, Thenjiwe Rose |
| Contributors | Mukumbang, Ferdinand |
| Publisher | University of Western Cape |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Rights | University of Western Cape |
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