A Qualitative Study to Identify Perceptual Barriers to Antiretroviral Therapy (ART) Uptake and Adherence in HIV Positive People from UK Black African and Caribbean Communities

AIDS Behav. 2019 Sep;23(9):2514-2521. doi: 10.1007/s10461-019-02670-x.

Abstract

To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART.

Keywords: Adherence; Antiretroviral; Beliefs; Concerns; HIV; Necessity.

MeSH terms

  • Adult
  • Africa South of the Sahara / ethnology
  • Black People / ethnology
  • Black People / psychology*
  • Caribbean Region / ethnology
  • Cross-Sectional Studies
  • Disclosure
  • Fear*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Medication Adherence / ethnology
  • Medication Adherence / psychology*
  • Middle Aged
  • Perception
  • Qualitative Research
  • Religion
  • Social Stigma
  • United Kingdom / epidemiology