Barriers to and Factors Facilitating Adherence to Antiretroviral Therapy from the Perspectives of Patients in Mäqälä City, Tǝgray Region, Ethiopia

Abstract

The decentralization and free provision of life-saving antiretroviral therapy (ART) to health centers in Ethiopia began in 2006. In the Tǝgray Region, the number of people who began ART increased almost tenfold between 2006 and 2010, yet treatment retention among these patients has been challenging. This qualitative analysis explores the experiences of patients who either continued or interrupted adherence to ART. Conducted at three health facilities in Mäqälä City from August to October 2009, the aim of this study was to document the facilitating factors and barriers to ART adherence from patients’ perspectives.

For both continued and interrupted adherence, the most common facilitating factors are a belief in the efficacy of the medication, trust in the health-care providers, low level of side effects, positive treatment results, and having an HIV-positive friend. Each restarter had distinctive reasons for interrupting the ART. Major contributing factors to ART interruption were the side effects and fear of stigma or discrimination.

In urban neighborhoods with a high volume of rural migration, where people lived far from their extended families, ART patients were more dependent on health workers for adherence support.