The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa

Background: The effectiveness of antiretroviral therapy (ART) and the importance of adherence to treatment regimens are widely known. Yet, suboptimal adherence to ART and retention in care of patients still persists and, by many accounts, is fairly widespread. The aim of this study was to identify t...

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Main Authors: A. Kagee, J. Nothling, B. Coetzee
Format: Article
Language:English
Published: AOSIS 2012-12-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/2268
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author A. Kagee
J. Nothling
B. Coetzee
author_facet A. Kagee
J. Nothling
B. Coetzee
author_sort A. Kagee
collection DOAJ
description Background: The effectiveness of antiretroviral therapy (ART) and the importance of adherence to treatment regimens are widely known. Yet, suboptimal adherence to ART and retention in care of patients still persists and, by many accounts, is fairly widespread. The aim of this study was to identify the structural barriers that influenced adherence among patients who were enrolled in the national ART programme in South Africa. Method: In this qualitative study, semi-structured interviews were conducted with a sample of 10 patients receiving ART at a public hospital in South Africa. Results: The results of the interviews were categorised according to poverty-related, institution-related and social barriers to clinic attendance and pill-taking, which collectively formed the structural barriers to adherence. The chief structural barriers to clinic attendance were time away from work, transport expenses, long waiting times and negative experiences with clinic staff. The chief barriers to pill-taking were food insecurity, stigma and discrimination. Conclusion: The barriers to adherence are discussed. Attention is called to the extraindividual factors that influenced ART adherence. We conclude that contextual factors, such as a healthcare-enabling environment, might play an important role in influencing healthcare-promoting behaviour among patients.
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spelling doaj-art-ebfad35eadb64c778df041df654afdc22025-08-20T04:03:13ZengAOSISSouth African Family Practice2078-61902078-62042012-12-0154610.1080/20786204.2012.108742894709The perspectives of users of antiretroviral therapy on structural barriers to adherence in South AfricaA. Kagee0J. Nothling1B. Coetzee2Department of Psychology, Stellenbosch UniversityDepartment of Psychology, Stellenbosch UniversityDepartment of Psychology, Stellenbosch UniversityBackground: The effectiveness of antiretroviral therapy (ART) and the importance of adherence to treatment regimens are widely known. Yet, suboptimal adherence to ART and retention in care of patients still persists and, by many accounts, is fairly widespread. The aim of this study was to identify the structural barriers that influenced adherence among patients who were enrolled in the national ART programme in South Africa. Method: In this qualitative study, semi-structured interviews were conducted with a sample of 10 patients receiving ART at a public hospital in South Africa. Results: The results of the interviews were categorised according to poverty-related, institution-related and social barriers to clinic attendance and pill-taking, which collectively formed the structural barriers to adherence. The chief structural barriers to clinic attendance were time away from work, transport expenses, long waiting times and negative experiences with clinic staff. The chief barriers to pill-taking were food insecurity, stigma and discrimination. Conclusion: The barriers to adherence are discussed. Attention is called to the extraindividual factors that influenced ART adherence. We conclude that contextual factors, such as a healthcare-enabling environment, might play an important role in influencing healthcare-promoting behaviour among patients.https://safpj.co.za/index.php/safpj/article/view/2268adherenceantiretroviral therapystructural barriers
spellingShingle A. Kagee
J. Nothling
B. Coetzee
The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
South African Family Practice
adherence
antiretroviral therapy
structural barriers
title The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
title_full The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
title_fullStr The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
title_full_unstemmed The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
title_short The perspectives of users of antiretroviral therapy on structural barriers to adherence in South Africa
title_sort perspectives of users of antiretroviral therapy on structural barriers to adherence in south africa
topic adherence
antiretroviral therapy
structural barriers
url https://safpj.co.za/index.php/safpj/article/view/2268
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