Sambayi Godfrey L, Bwire George M, Kilapilo Mary Spicar, Myemba David T, Mosha Idda H, Kilonzi Manase, Magati Renatus B, Amour Maryam, Mwakalukwa Rogers, Mangara Ally Nassoro, Bakari Muhammad, Sudfeld Christopher R, Matee Mecky I N, Sangeda Raphael Z, Adams Lisa V, Killewo Japhet
Department of Pharmacognosy, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, 65013, Tanzania.
Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research Clinical and Epidemiological Virology, Institute for the Future, KU Leuven, Leuven, 3000, Belgium.
HIV AIDS (Auckl). 2024 Jul 26;16:301-311. doi: 10.2147/HIV.S458545. eCollection 2024.
PURPOSE: To explore the enabling factors, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among adults (18 years and above) living with HIV in Dar es Salaam, Tanzania. METHODS: We conducted a descriptive qualitative study to better understand and explore enablers, barriers, and strategies to improve retention in HIV care and adherence to antiretroviral therapy (ART) among PLHIV in Dar es Salaam, Tanzania. Focus group discussions (FGD) were conducted with a semi-structured discussion guide between December 2021 and June 2022. A non-random purposive sampling technique was used to select PLHIV and people involved in provision of healthcare and socioeconomic support to PLHIV. Thematic analysis was used to identify and interpret the themes. RESULTS: Three major themes with 10 sub-themes emerged. Participants indicated that family and partner support, peer-support group/adherence clubs, and healthcare provider counselling on medication adherence facilitated retention and adherence to ART. In contrast, stigma and discrimination, financial constraints, disease outbreaks such as the COVID-19 pandemic, myths and misconceptions about HIV, and side effects of antiretrovirals were mentioned as barriers. Strengthening community and patient education about HIV and ART through peer support groups and financial support for poor PLHIV were the proposed mitigation. CONCLUSION: Addressing the challenges to ART adherence may require a more holistic approach. We recommend the implementation of peer support groups and financial support through small microfinance groups as interventions to increase retention in HIV care and adherence to ART in the study area.
目的：探讨坦桑尼亚达累斯萨拉姆18岁及以上感染艾滋病毒的成年人在接受艾滋病毒护理方面保持留存率以及坚持抗逆转录病毒治疗（ART）的促进因素、障碍和策略。 方法：我们开展了一项描述性定性研究，以更好地理解和探索坦桑尼亚达累斯萨拉姆感染艾滋病毒的人在接受艾滋病毒护理方面保持留存率以及坚持抗逆转录病毒治疗（ART）的促进因素、障碍和策略。2021年12月至2022年6月期间，使用半结构化讨论指南进行了焦点小组讨论。采用非随机目的抽样技术，选取感染艾滋病毒的人以及为感染艾滋病毒的人提供医疗保健和社会经济支持的人员。采用主题分析法来识别和解释主题。 结果：出现了三个主要主题和10个子主题。参与者表示，家庭和伴侣的支持、同伴支持小组/依从性俱乐部以及医疗保健提供者关于药物依从性的咨询有助于保持留存率和坚持抗逆转录病毒治疗。相比之下，耻辱和歧视、经济限制、诸如新冠疫情等疾病爆发、对艾滋病毒的误解和错误观念以及抗逆转录病毒药物的副作用被提及为障碍。建议通过同伴支持小组加强社区和患者对艾滋病毒和抗逆转录病毒治疗的教育，并为贫困的感染艾滋病毒的人提供经济支持，以此作为缓解措施。 结论：应对抗逆转录病毒治疗依从性方面的挑战可能需要采取更全面的方法。我们建议通过小型小额信贷团体实施同伴支持小组和经济支持，作为增加研究地区艾滋病毒护理留存率和抗逆转录病毒治疗依从性的干预措施。
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