Table 1 Themes of adherence to medication among HIV positive pregnant women included in qualitative studies (N = 15)
Domain | Themes | References (study numbers) |
|---|---|---|
Patient | Psychological | |
Shock/denial following a positive HIV result | [1, 6, 9, 14] | |
Motivation to protect infant/self/family | [6, 9, 10] | |
Patient knowledge on ART/PMTCT | ||
Poor knowledge of ART, MTCT | [4] | |
Good knowledge of ART | [3] | |
Self-efficacy | ||
Self-reported ability to adhere to ART | [6, 8] | |
Patient attitude and personal management | ||
Late ANC attendance an obstacle to early AZT prophylaxis and initiation on HAART | [2] | |
Missing clinical appointments | [1] | |
Interrupted personal routine | [4] | |
Patient belief system | ||
Religious belief | [13] | |
Use of traditional medicines | [5] | |
Patient condition | Disease progression | [13] |
Obstetric/ pregnancy | ||
Uncertainty about onset of labour in order to swallow NVP | [1] | |
Previous experience with PMTCT | [9] | |
Therapy | Side effects of ART | [6, 13] |
Perceived effectiveness of therapy | [6, 9] | |
Social and economic factors | Financial difficulty | |
Lack of transport fee to go to health facility for pick-up of ARVs | [1, 2, 3, 13] | |
Lack of money to buy food to eat | [3, 4, 13] | |
Women empowerment | ||
Economically dependent on husbands | [3] | |
Domestic violence either actual or threatened | [4] | |
Lack of male involvement | [2] | |
Cultural conditions and beliefs | ||
Traditional medicines/healers | [4, 5] | |
Religious beliefs | [13] | |
Partner and community – the challenges of disclosure and non-disclosure | ||
Fear of disclosure to partner/family members | [3, 4, 5, 8, 9, 10, 13, 14] | |
Disclosure to partner/family(facilitating) | [8, 13] | |
HIV infected relatives stealing tablets | [4] | |
Hiding ARVS within the house/taking ARVs in hiding in the house | [4, 5] | |
Pattern of misinformation on ART in the community | [14] | |
HIV related stigma | [2, 5, 9, 10, 13, 15] | |
Community view of HIV- infected persons had no bearing on their decision to begin or continue ART | [3] | |
Sharing medication with others | ||
Sharing ARVs with partner/friend | [1, 4] | |
Positive outlook of known patients living with HIV in the community | ||
Seeing positive results in the community of women taking ART and looking healthy | [9, 10, 12] | |
Health care team/health system | Staff related | |
Fear of mistreatment by HCWs | [1, 3, 7, 10] | |
HCWs providing good counselling on ART | [6, 7, 8] | |
Supply chain management system | ||
Delayed supply of ARVs | [2, 6, 7] | |
Resource/Infrastructure and service related | ||
Prolonged counselling to initiate prophylaxis or ART | [2, 3] | |
Lack of privacy and confidentiality | [2, 7] | |
Inadequate counselling and short contact time with patient | [2] | |
Long waiting time in the health facilities | [3, 11] |