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Open Access Research article

Understanding the facilitators and barriers of antiretroviral adherence in Peru: A qualitative study

Walter H Curioso12*, Deanna Kepka3, Robinson Cabello4, Patricia Segura5 and Ann E Kurth67

Author Affiliations

1 Epidemiology, STD/AIDS Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Honorio Delgado 430, Lima 31, Peru

2 Division of Biomedical and Health Informatics, Department of Medical Education and Biomedical Informatics, School of Medicine, University of Washington, Seattle, WA 98195, USA

3 Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA

4 Asociación Vía Libre, Paraguay 478, Lima 1, Peru

5 Asociación Civil Impacta Salud y Educación, Grimaldo del Solar 805, Lima 18, Peru

6 Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Seattle, WA 98195, USA

7 Current address: New York University College of Nursing, 726 Broadway, 10th Floor, New York, NY 10003, USA

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BMC Public Health 2010, 10:13  doi:10.1186/1471-2458-10-13

Published: 13 January 2010

Abstract

Background

Antiretroviral scale-up is increasing in resource-constrained settings. To date, few studies have explored the barriers and facilitators of adherence to ART in these settings. Facilitators and barriers of antiretroviral adherence in Peru are not completely understood.

Methods

At two clinics that serve a large number of HIV-positive individuals in Lima, Peru, 31 in-depth interviews were carried out in 2006 with adult HIV-positive individuals receiving ART. Purposive sampling was used to recruit the participants. Interviews were transcribed and coded using two Spanish-speaking researchers and a content analysis approach to identify themes in the data.

Results

Among the participants, 28/31 (90%) were male, 25/31 (81%) were self-identified as mestizo, and 19/31 (61%) had an education above high school. The most frequently discussed barriers to adherence included side effects, simply forgetting, inconvenience, dietary requirements, being away from home, and fear of disclosure/stigma. The most frequently discussed facilitators to adherence included having a fixed routine, understanding the need for compliance, seeing positive results, treatment knowledge, and faith in treatment.

Conclusions

Overall, these findings were similar to the facilitators and challenges experienced by individuals on ART in other resource constrained settings. Further treatment support tools and networks should be developed to decrease the challenges of ART adherence for HIV-positive individuals in Lima, Peru.