title: Reasons for unsatisfactory acceptance of antiretroviral treatment in the urban Kibera slum, Kenya.
abstract: The aim of this study was to explore why patients in the urban Kibera slum, Nairobi, Kenya, offered free antiretroviral treatment (ART) at the Médecins Sans Frontièrs (MSF) clinic, choose not to be treated despite signs of AIDS. Qualitative semi-structured interviews were conducted with 26 patients, 9 men and 17 women. Six main reasons emerged for not accepting ART: a) fear of taking medication on an empty stomach due to lack of food; b) fear that side-effects associated with ART would make one more ill; c) fear of disclosure and its possible negative repercussions; d) concern for continuity of treatment and care; e) conflicting information from religious leaders and community, and seeking alternative care (e.g. traditional medicine); f) illiteracy making patients unable to understand the information given by health workers.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. christianunge@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Unge
authors.forename: A
authors.initials: A
authors.lastname: Johansson
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.forename: D
authors.initials: D
authors.lastname: Some
authors.forename: I
authors.initials: I
authors.lastname: Van Engelgem
authors.forename: A M
authors.initials: AM
authors.lastname: Ekstrom
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D016312:Treatment Refusal / Q000523:psychology*
chemical_list: D019380:Anti-HIV Agents