To explore patients’ perceptions about motivators and barriers of adherence to highly active antiretroviral therapy among people living with HIV: A qualitative study

Abstract

ABSTRACT Objective: For people living with HIV (PLHIV), strict adherence to highly active antiretroviral therapy (HAART) is the key to effective treatment and retention in human immunodeficiency virus (HIV) care. There are many factors which promote or halt the antiretroviral therapy (ART) adherence practices. Therefore, the present study aimed to examine the HAART adherence levels and to explore patients’ views about barriers and facilitators to HIV treatment adherence. Methods: Semi-structured interviews were conducted among 15 PLHIV at the ART clinic of Dr. Ram Manohar Lohia Hospital, New Delhi. Interviews were audio-recorded in the local Hindi language, and bilingual experts (English and Hindi) transcribed verbatim. Qualitative data were coded for themes and subthemes and analyzed using a phenomenological approach as per thematic content analysis. Results: Feeling of hopelessness, delayed ART initiation, difficult initial phase of ART, forget to take ART on time, fear of disclosure of HIV diagnosis, lack of privacy and negative social support, and impact of lockdown due to COVID-19 were revealed as significant barriers to ART adherence. At the same time, commitment to raise and educate children, ART to increase life span, maintain oneself to be physically fit and healthy, only a single pill per day, very supportive counselors and health-care professionals, and hope to give birth to a healthy child were identified as facilitators of HIV retention. Conclusion: Understanding patient’s perception about ART adherence, its motivational and barrier factors which are directly affecting ART adherence and retention of PLHIV in HIV treatment and follow-ups are of utmost importance to improve ART adherence during HIV patient care services.