title: The price of adherence: qualitative findings from HIV positive individuals purchasing fixed-dose combination generic HIV antiretroviral therapy in Kampala, Uganda.
abstract: Contrary to early expectations, recent studies have shown near-perfect adherence to HIV antiretrovirals in sub-Saharan Africa We conducted qualitative interviews with patients purchasing low-cost, generic antiretroviral therapy to better understand the social dynamics underlying these findings. We found that concerns for family well-being motivate adherence, yet, the financial sacrifices necessary to secure therapy may paradoxically undermine family welfare. We suggest that missed doses may be more due to a failure to access medication rather than a failure to adhere to medications, and that structural rather than behavioral interventions may be most useful to insure optimal treatment response.
authors.affiliation: Department of Anthropology, History and Social Medicine, UCSF, San Francisco, California 94143, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Crane
authors.forename: A
authors.initials: A
authors.lastname: Kawuma
authors.forename: J H
authors.initials: JH
authors.lastname: Oyugi
authors.forename: J T
authors.initials: JT
authors.lastname: Byakika
authors.forename: A
authors.initials: A
authors.lastname: Moss
authors.forename: P
authors.initials: P
authors.lastname: Bourgois
authors.forename: D R
authors.initials: DR
authors.lastname: Bangsberg
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D002391:Catchment Area, Health; D017281:Cost of Illness; D004359:Drug Therapy, Combination; D016568:Drugs, Generic; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010349:Patient Compliance; D014454:Uganda / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents; D016568:Drugs, Generic