Table 4 Enabling/disabling factors of ART access and adherence among OPLWH
ABM Domain | Barrier/Facilitator | Select quote | Access | Adherence |
|---|---|---|---|---|
Enabling factors | Transportation | ‘I get challenged by money for transport especially when it comes to time for collecting my drugs from the {name} clinic. Sometime I miss appointment dates when I have to collect drugs due to lack of transport until I inform children to send me money.’ Man, aged 60–69 | ✔ | |
Mobility | Reporting on the hardest part of accessing her treatment and making sure she takes her medication on time and when required, the old woman explained that nothing would have been hard for her but because of her painful feet, walking becomes hard though she tries to report as required when the appointed date has come. Woman on ART, aged 70–79 | ✔ | ||
Reminder strategies | ‘I have a phone and a radio which enables me know the right time and when I happen to have gone somewhere, I cannot leave my drugs behind and I never miss a single day. Taking It (ART) is like taking food because without food one cannot remain strong and healthy.’ Man on ART, aged 60–70 | ✔ | ||
Medication characteristics: Side effects | ‘The tablets that MRC health workers gave me reduced the strength (sexual strength/desire.) I then asked them to delete me out of their books. (To exclude his name out of those that had been enrolled for care.) That the tablets had even caused me loss of appetite and did not know how I would survive without taking food.’ Man, aged 80-plus | ✔ | ||
Poverty: Food insecurity | ‘They (the health workers) tell you thus; ‘you have to swallow the drugs after you have taken something (food.) However, there are times when I do not swallow the drugs having failed to get what to eat and I become confused!’ Woman on ART, aged 60–70 | ✔ | ||
Travel | ‘One time I lost a relative and went for the funeral at Gomba where I spent a week. The drugs got finished while I was still there. When I returned and went to the health facility, I apologized to the health workers for what had happened then they asked me to bring with me someone who I would send for my drugs in case I was unable to collect it due to unavoidable occurrences or when I have become sick and unable to go and pick it!’ Woman on ART, aged 60–70 | ✔ | ✔ | |
Disclosure: kin & community support | ‘We (himself and wife) talk about collecting our HIV drugs at the facility and also remind each other when it comes to time of swallowing it.’ Man on ART, aged 50–59 Those days I didn’t have any partner but these days after getting a partner, I do not collect drugs myself, I use a friend to collect it for me. I give her a record book and for her wait to go to the health facility at six months to check her CD4 and the viro-load. My friend who collects my drugs is also HIV positive and brings it when she has gone to collect her own.’ Woman on ART, aged 50–59 | ✔ | ✔ |