Factors Influencing ART Adherence Among Persons Living with HIV Enrolled in Community Client-Led Art Delivery Groups in Lira District, Uganda: A Qualitative Study

Rogers Isabirye; Didan Jacob Opii; Sharon Opio Ekit; Alice Kawomera; Luke Lokiru; Robert Isoke; Joachim Ssenkaali; Sean Steven Puleh

doi:10.2147/HIV.S414971

Factors Influencing ART Adherence Among Persons Living with HIV Enrolled in Community Client-Led Art Delivery Groups in Lira District, Uganda: A Qualitative Study

HIV AIDS (Auckl). 2023 Jun 15:15:339-347. doi: 10.2147/HIV.S414971. eCollection 2023.

Authors

Rogers Isabirye¹, Didan Jacob Opii¹, Sharon Opio Ekit², Alice Kawomera², Luke Lokiru³, Robert Isoke¹, Joachim Ssenkaali⁴, Sean Steven Puleh³

Affiliations

¹ Department of Midwifery and Nursing, Faculty of Health Sciences, Lira University, Lira, Uganda.
² Department of Psychiatry, Faculty of Medicine, Lira University, Lira, Uganda.
³ Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, Lira, Uganda.
⁴ Department of Physiology, Faculty of Medicine, Lira University, Lira, Uganda.

Abstract

Background: Community client-led ART delivery groups (CCLADs) were introduced as one of the strategies to better serve individual needs and reduce unnecessary burdens on the health system. However, limited data adequately explained the factors influencing ART adherence among HIV/AIDS patients in CCLAD's model of care. The study aimed to assess the factors influencing ART adherence among HIV-positive patients attending CCLADs in Lira District, Uganda.

Materials and methods: We employed a qualitative method of data collection recruiting 25 study participants (expert clients) between July and August 2020. The study purposefully chose 25 participants to participate in with HIV/AIDS patients enrolled in community-based HIV care models. The interviews were recorded on audiotape, transcribed, and translated verbatim. We used a thematic approach to analyze the data.

Results: Our study shows that social support among group members, patient self-motivation, counselling, and guidance were the major facilitators of adherence. From the analysis of results, our study found the following themes: Lack of food, stigma, forgetfulness, stress, unfair staff at the hospital, and socio-cultural beliefs were among the major barriers identified in this study.

Conclusion: The study emphasizes that CCLADs improve ART adherence for HIV-positive clients by providing a supportive environment and medication access. Peer influence on alternative medicine usage hinders adherence. We recommend that continued support, funding, and education are necessary to address misconceptions and sustain CCLADs' effectiveness.

Keywords: HIV/AIDS; barriers; community client-led ART delivery; facilitators.

Grants and funding

Research reported in this publication was supported by the Fogarty International Center (US Department of State’s Office of the US Global AIDS Coordinator and Health Diplomacy [S/GAC] and the President’s Emergency Plan for AIDS Relief [PEPFAR]) of the National Institutes of Health under Award Number R25TW011210. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.