3.8 Article

Knowledge, opinions, and experiences of stigma as a barrier to antiretroviral therapy adherence among HIV community volunteers and health care givers in an urban slum, in Uganda

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WOLTERS KLUWER MEDKNOW PUBLICATIONS
DOI: 10.4103/1755-6783.190180

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Adherence; antiretroviral therapy; HIV; stigma

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Background: This study was aimed at examining how stigma negatively affects adherence to antiretroviral therapy (ART) in urban slum, Uganda, by exploring the knowledge, experiences, and opinions of health care givers and human immunodeficiency virus (HIV) community volunteers in order to propose appropriate strategies to improve ART adherence Materials and Methods: A qualitative research involving 15 semistructured interviews at Kawempe Home Care Initiative, Kampala, Uganda. Semistructured interviews were with 10 HIV community volunteers from both Kawempe and Kasangati as well as 5 health care givers who work at Kawempe and on outreach programms at Kasangati. Interviews were transcribed and data coded by thematic analysis Results: Stigma was well known and interpreted among health care givers and HIV community volunteers. Knowledge, opinions, and experiences about stigma related to ART were in depth and diverse. Possible strategies to address stigma and subsequently improve ART adherence were agreed as suitable. These included community education, training of more HIV community volunteers, increase counselling, increased family support, and behavioral change Conclusion: Knowledge about stigma is insufficient to promote adherence, but cultural issues in society should be addressed while educating and sensitizing people on stigma so as to promote adherence to ART. In addition, stigma and disclosure are interrelated phenomena that affect takers of antiretroviral drugs to adhere to medication.

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