Barriers to Retention in Care as Perceived by Persons Living with HIV in Rural Ethiopia: Focus Group Results and Recommended Strategies

Inability to retain HIV-infected patients in care undermines the benefits of starting millions in low-income countries on antiretroviral therapy (ART). In a hospital HIV clinic in rural southern Ethiopia, we conducted focus groups of HIV-infected men and women to learn more about experiences with an...

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Bibliographic Details
Published in:Journal of the International Association of Providers of AIDS Care 2013-02, Vol.12 (1), p.32-38
Main Authors: Lifson, Alan R., Demissie, Workneh, Tadesse, Alemayehu, Ketema, Kassu, May, Randy, Yakob, Bereket, Metekia, Meka, Slater, Lucy, Shenie, Tibebe
Format: Article
Language:English
Subjects:
Adult
Anti-Retroviral Agents - administration & dosage
Anti-Retroviral Agents - adverse effects
Crowding
Ethiopia - epidemiology
Female
Focus Groups
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Health Services Needs and Demand
HIV Infections - drug therapy
HIV Infections - epidemiology
Humans
Male
Medication Adherence
Outpatient Clinics, Hospital
Prejudice
Professional-Patient Relations
Rural Population
Social Stigma
Socioeconomic Factors
Substance-Related Disorders - epidemiology
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Summary:Inability to retain HIV-infected patients in care undermines the benefits of starting millions in low-income countries on antiretroviral therapy (ART). In a hospital HIV clinic in rural southern Ethiopia, we conducted focus groups of HIV-infected men and women to learn more about experiences with and barriers to attending clinic appointments. Respondents reported multiple barriers, including those that were patient related (eg, misunderstandings about ART, mistaken belief in AIDS cures, and drug/alcohol use), clinic related (eg, negative provider interactions, lack of familiarity with patients’ medical situation, and overcrowding), medication related (eg, side effects), social (eg, stigma and discrimination and lack of support), and situational/resource related (eg, distance to clinic, lack of funds, competing domestic/work priorities, and lack of food). Based on the lessons learned from these focus groups, we implemented a community intervention to improve retention, using trained community support workers who provide patient education, counseling, social support, problem-solving assistance, needed referrals, and improved communication/linkage to the patients’ HIV clinic.
ISSN:2325-9574
2325-9582
2325-9582
DOI:10.1177/1545109712456428