Barriers to accessing highly active antiretroviral therapy by HIV-positive women attending an antenatal clinic in a regional hospital in western Uganda.
BACKGROUND
The aim of this study was to describe barriers to accessing and accepting highly active antiretroviral therapy (HAART) by HIV-positive mothers in the Ugandan Kabarole District's Programme for the Prevention of Mother to Child Transmission-Plus (PMTCT-Plus).


METHODS
Our study was a qualitative descriptive exploratory study using thematic analysis. Individual in-depth interviews (n = 45) were conducted with randomly selected HIV-positive mothers who attended this programme, and who: (a) never enrolled in HAART (n = 17); (b) enrolled but did not come back to receive HAART (n = 2); (c) defaulted/interrupted HAART (n = 14); and (d) are currently adhering to HAART (n = 12). A focus group was also conducted to verify the results from the interviews.


RESULTS
Results indicated that economic concerns, particularly transport costs from residences to the clinics, represented the greatest barrier to accessing treatment. In addition, HIV-related stigma and non-disclosure of HIV status to clients' sexual partners, long waiting times at the clinic and suboptimal provider-patient interactions at the hospital emerged as significant barriers.


CONCLUSIONS
These barriers to antiretroviral treatment of pregnant and post-natal women need to be addressed in order to improve HAART uptake and adherence for this group of the population. This would improve their survival and, at the same time, drastically reduce HIV transmission from mother to child.
Duff
Putu
P
School of Public Health, University of Alberta, Canada.
Kipp
Walter
W
Wild
T Cameron
TC
Rubaale
Tom
T
Okech-Ojony
Joa
J
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005069:Evaluation Studies as Topic; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics / Q000517:prevention & control / Q000523:psychology*; D006679:HIV Seropositivity; D006297:Health Services Accessibility / Q000191:economics; D006761:Hospitals; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000191:economics / Q000517:prevention & control; D007406:Interview, Psychological; D010349:Patient Compliance; D011247:Pregnancy; D014454:Uganda; D014930:Women / Q000193:education / Q000523:psychology*; D055815:Young Adult