Abstract / Summary
This study examined factors contributing to non-adherence to Antiretroviral Therapy (ART) among HIV/AIDS patients at Mbalizi Hospital, Mbeya Rural District, Tanzania. It addressed two specific objectives: assessing patients’ awareness of ART and identifying factors contributing to ART non-adherence. A qualitative case study design, guided by the Health Belief Model and Social Cognitive Theory, was employed. Data were collected through semi-structured interviews, focus group discussions, and observation from 25 purposively selected participants, comprising 18 HIV/AIDS patients and 7 healthcare providers at the Care and Treatment Clinic (CTC). Data were analysed thematically using Braun and Clarke’s six-step approach, with findings supported by verbatim participant quotations. The findings showed that most patients had a general understanding of ART, although their knowledge developed progressively with treatment duration. Newly enrolled patients were particularly likely to hold misconceptions regarding when ART could safely be discontinued. ART non-adherence resulted from interacting individual, social, and health service-related factors. Individual factors included forgetfulness, medication side effects, alcohol use, food insecurity, and treatment complacency. Social factors involved stigma, fear of disclosure, inadequate family support, and conflicting cultural and religious beliefs. Health service-related factors included long waiting times, inadequate staffing, and occasional drug shortages. The study concludes that ART non-adherence is multidimensional and requires coordinated interventions addressing patient, social, and health system factors. It recommends strengthening patient education, decentralising ART services, providing differentiated care, enhancing nutritional and economic support, reducing community stigma, and systematically tracing patients who miss appointments.