Conceptualising the factors affecting retention in care of patients on antiretroviral treatment in Kabwe District, Zambia, using the ecological framework
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Hindawi Publishing Corporation
Abstract
BACKGROUND. HIV remains a major public health challenge in Zambia.The roll-out of antiretroviral treatment (ART) has engendered
new challenges in retention in care. OBJECTIVE. To conceptualise the factors affecting retention in care of ART patients at three
primary healthcare facilities using the ecological framework. METHOD. Qualitative data were collected through in-depth interviews
with 45 ART patients and three focus group discussions with 20 healthcare providers from three primary healthcare facilities in
Kabwe district, Zambia, and subjected to thematic content analysis. RESULTS. Individual level barriers to retention in care included
side effects, gaining weight, belief in faith healing, and use of herbal remedies and alcohol. Interpersonal barriers such as stigma
and nondisclosure of HIV status were reported. At the institutional level, inadequate space in the clinic, long waiting times, long
travel distances, and shortage of third-line drugs presented barriers to retention in care. Food shortages and patient mobility were
reported as community barriers to retention in care. CONCLUSION.The ecological framework conceptualises the complex and dynamic
factors affecting retention inART care and highlights the need formultifaceted interventions that combine health education, disease
management, and opportunities for income generation in a socially responsive and accountable environment.
Description
Keywords
HIV, Public health challenge, Zambia, Care, Retention
Citation
Mukumbang, F.C. et al. (2017). Conceptualising the factors affecting retention in care of patients on antiretroviral treatment in Kabwe District, Zambia, using the ecological framework. AIDS Research and Treatment, 2017: 7356362