The price of adherence: qualitative findings from HIV positive individuals purchasing fixed-dose combination generic HIV antiretroviral therapy in Kampala, Uganda.
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.
Crane
J T
JT
Department of Anthropology, History and Social Medicine, UCSF, San Francisco, California 94143, USA.
Kawuma
A
A
Oyugi
J H
JH
Byakika
J T
JT
Moss
A
A
Bourgois
P
P
Bangsberg
D R
DR
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
D044966:Anti-Retroviral Agents; D016568:Drugs, Generic