title: Perceptions regarding barriers and facilitators to combination antiretroviral therapy adherence among people living with HIV/AIDS in Gujarat, India: A qualitative study.
abstract: OBJECTIVE
  To know the perceptions regarding barriers and facilitators to cART adherence among people living with HIV/AIDS  MATERIALS AND METHODS: To adapt U.S. based SAFETALK "prevention with positives" intervention to be culturally relevant in Gujarat, India in assisting PLWHA, a formative study was conducted. We conducted 30 in-depth interviews with PLWHA in the local language, assessing the experiences, perceived barriers, and facilitators to combination antiretroviral therapy (cART) among PLWHA in Gujarat. PLWHA were selected from the Voluntary Counseling and Testing Centre (VCTC) in Gujarat. To triangulate interview findings, we conducted two focus group discussions (FGDs) with medical and non-medical providers, respectively.
  
  
  RESULTS
  Travel and commuting to clinic, fear of possible physical reactions, high cost of ART from private practitioners, CD4 count being in normal limits and resistance to medication acted as barriers to cART adherence. Initiation of cART was facilitated by family members' suggestion, advice of treating doctors and counselors, appropriate counseling before starting cART, belief that cART would aid in living a better and longer life and due to lowering of the CD4 count.
  
  
  CONCLUSIONS
  Our study suggests that several issues need to be considered when providing cART. Further research is needed to study interactions between patients and their health care providers.
authors.affiliation: Department of Community Medicine Medical College Baroda, Gujarat, India.
authors.forename: Sangita
authors.initials: S
authors.lastname: Patel
authors.forename: Rajendra K
authors.initials: RK
authors.lastname: Baxi
authors.forename: Shilpa N
authors.initials: SN
authors.lastname: Patel
authors.forename: Carol E
authors.initials: CE
authors.lastname: Golin
authors.forename: Mansi
authors.initials: M
authors.lastname: Mehta
authors.forename: Harsh
authors.initials: H
authors.lastname: Bakshi
authors.forename: Kalpita
authors.initials: K
authors.lastname: Shingrapure
authors.forename: Ekta
authors.initials: E
authors.lastname: Modi
authors.forename: Priyanka
authors.initials: P
authors.lastname: Coonor
authors.forename: Kedar
authors.initials: K
authors.lastname: Mehta