Barriers and facilitators of Highly Active Antiretroviral Therapy (HAART) adherence among HIV-positive Women in Southern Ethiopia: A Qualitative study

BackgroundAdherence to Highly Active Antiretroviral Therapy (HAART) medication is the major predictor of HIV/AIDS treatment success. Poor adherence to HAART creates the risk of transmitting HIV, deteriorating health conditions, treatment failure, increased occurrences of drug-resistant HIV, morbidity and mortality. The objective of this study was to explore and describe the experiences of HAART adherence among HIV-positive women in Southern Ethiopia. MethodsSemi-structured in-depth interviews (IDIs) were conducted with 12 HIV-positive women in Southern Ethiopia who are adhering and non-adhering to HAART. Interviews were conducted in the local Amharic language and audio recorded with permission from the participants. The interviews were transcribed verbatim, coded for themes, categories and sub-categories and analyzed using a thematic data analysis technic. ResultsThe findings of the study reflected two themes: barriers and facilitators of HAART medication adherence among HIV-positive women. Barriers and facilitators were further categorized into 5 categories. These included patient-related factors, treatment-related factors, psychosocial-related factors, family and community-related factors, and healthcare services-related factors. These categories were further divided into 22 sub-categories. Busy schedule, forgetting the doses, rituals of religion, economic constraints, drug side-effects, pills burden and size, misconceptions about HIV, negative attitudinal disposition towards HAART, refusal to adhere to HAART, depression, lack of hope and courage, stigma and discrimination, relationship with healthcare providers, a working day of HAART clinic, and long waiting time were identified as barriers to HAART adherence. While, family responsibilities, reminder devices, dosage formulation, perceived benefit of HAART, family support, adherence to supporting peer groups, and adherence to counselling/education were identified as facilitators of HAART adherence. ConclusionsAdherence to HAART medication is a major challenge among HIV-positive women in Southern Ethiopia. Therefore, tailored strategies to enhance HAART medication adherence should be targeted addressing the barriers identified in the study.