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Abstract: Human Immunodeficiency Virus is one of the most serious public health threats of
the 21st century, with over 40 million people having died and more continuing
to die due to HIV-related diseases. Although Antiretrovirals (ARVs) are to mitigate the effects of HIV exist, there are
People Living with HIV (PLHIV) who still default from Antiretrovirals, putting
their health at risk. This study explored the factors contributing to ARV
default among PLHIV at a Community Health Center in Northwest Province, South
Africa.
The study
objectives were to explore personal and socio-economic barriers to HIV
treatment adherence, and health systems barrier to HIV treatment adherence.
Methods: This study employed a qualitative phenomenological
design. Data was collected using a semi-structured interview and interview
guide as a data collection tool. Individual in-depth interviews were conducted
with 12 purposively selected PLHIV aged 18–40 years who had defaulted from ARVs
by over 30-90 days and traced back to the clinic. Tesch’s framework was used to
generate themes from the data.
Results: The main factors contributing to ARV default included
health-related factors such as health professionals’ negative attitudes and
their lack of confidentiality, as well as long waiting times at the clinic and
shortage of ARV medication; patient's personal factors such as non-disclosure
of one’s HIV status, fear of discrimination from the community members,
treatment side effects, and denial of one’s HIV status; and socioeconomic
factors such as financial difficulties, including lack of transport money to
the clinic and work commitment.
Conclusion: Several factors have been identified as contributors to ARV treatment default in PLHIV. Intervention policies aimed at reducing the PLWHIV financial burden, long waiting times at the clinic, and strengthening post-HIV diagnosis counselling and education are required.
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