“The one who doesn’t take ART medication has no wealth at all and no purpose on Earth” – a qualitative assessment of how HIV-positive adults in Uganda understand the health and wealth-related benefits of ART

Table 2 Summary of themes describing multi-level effects of ART on Health and Wealth

Social Ecological Level	ART Benefits (“the effect of ART on…”)	Emerging themes	Relative frequency ^b
Individual (intrapersonal)	Health (lifestyle)^a	•Increased physical improvements and lowered susceptibility to illnesses •Adoption of positive long-term habits (e.g., improved nutrition and exercise) that help with physical and mental health	****
Individual (intrapersonal)	Wealth	•Increased financial earnings and accompanying savings from being able to work more regularly •Increased personal motivation to work harder (with monetary and non-monetary benefits)	******
Household (interpersonal)	Health (lifestyle) ^a	•Increased ability to do routine things (e.g. school, work, raise children) and plan for future •Reduced engagement in risky behaviors (e.g., unprotected sex and substance use) •Improved social support and motivation from peers and providers	******
Household (interpersonal)	Wealth	•Longer lifespan allows for more earning potential and meeting family responsibilities •Improved social ties (leading to more friends and business opportunities)	****
Structural	Health (lifestyle) ^a	•Disclosure to close friends and family •Lowered stigma due to lack of illness •Improved appreciation for health care providers •Role of fatalism and the inevitability of death	*********
Structural	Wealth	•Increased importance of forward-looking behavior and civic responsibility (e.g., building businesses to help the economy, helping other PLWH)	***

^a The words “health” and “lifestyle” are interchangeable in the local context per the data collection team. As a result, when asked about the effects of ART on one’s health, many respondents provided responses focused on their life goals (e.g. job, home, family etc.) rather than discussing immediate health-related impacts. For the purposes of this analysis, we have combined those themes
^b Relative frequencies are denoted by: * discussed by < 25% of respondents (or n < 10), ** discussed by 25–50% of respondents (or n = 10–20), *** discussed by > 50% of respondents (or n > 20)

ISSN: 1471-2458