Abstract
Introduction: Human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/ AIDS) remains a major public health concern in South Africa, with millions of individuals living with the virus and a significant portion not adhering to antiretroviral therapy (ART). ART adherence is crucial for viral suppression, reducing transmission, and improving health outcomes. Despite its importance, many patients default on treatment due to various interrelated factors. This study addresses the gap by examining the experiences of Community Health Workers (CHWs) in Ingquza Hill Health Sub-District, who engage directly with patients and provide valuable insights into the causes of non-adherence.
Objective: This objective of this is to determine and describe the experiences of CHWs regarding factors influencing ART non-adherence among primary healthcare patients in Ingquza Hill Health Sub-District, Eastern Cape Province, South Africa.
Methods: A quantitative, cross-sectional descriptive study was conducted using an online survey questionnaire. Participants included 154 CHWs employed in the Ingquza Hill Health Sub-District. Data were collected electronically through a structured, closed-ended survey designed to capture the experiences of CHWs regarding individual, medical, healthcare, and socio-economic factors contributing to ART non-adherence. Statistical analysis, including frequency distribution and Spearman’s correlation, was used to interpret the data.
Results: The results revealed that individual-related factors such as forgetfulness (51.9%) and substance abuse (43.5%) were the most significant contributors to ART non-adherence. Healthcare-related factors such as long waiting times (33.8%) and poor access to facilities (32.5%) were also prominent. Medical-related factors, including difficulties with dose administration (32.5%), had a notable impact, while socio-economic barriers such as financial constraints (39%) further exacerbated non-adherence. Statistically significant correlations were observed between several of these factors.
Conclusion: The results confirm that ART non-adherence is a multidimensional issue influenced by a combination of individual behaviour, healthcare system inefficiencies, medical regimen complexity, and socio-economic hardships. These insights highlight the need for tailored, multifaceted interventions that address the most impactful barriers as identified by CHWs.