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The Price of Adherence: Qualitative Findings From HIV Positive Individuals Purchasing Fixed-Dose Combination Generic HIV Antiretroviral Therapy in Kampala, Uganda

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Contrary to early expectations, recent studies have shown near-perfect adherence to HIV antiretrovirals in sub-Saharan Africa We conducted qualitative interviews with patients purchasing low-cost, generic antiretroviral therapy to better understand the social dynamics underlying these findings. We found that concerns for family well-being motivate adherence, yet, the financial sacrifices necessary to secure therapy may paradoxically undermine family welfare. We suggest that missed doses may be more due to a failure to access medication rather than a failure to adhere to medications, and that structural rather than behavioral interventions may be most useful to insure optimal treatment response.

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ACKNOWLEDGMENTS

The authors would like to thank Mary Kasango for her assistance in data collection. This study was supported by the NIMH, NIAAA, NIDA, University of California San Francisco—Gladstone Institute of Virology and Immunology Center for AIDS Research, University of California, Berkeley Fogarty International AIDS Training Program, Doris Duke Charitable Foundation, and University of California, Berkeley Human Rights Center.

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Authors and Affiliations

  1. Department of Anthropology, History and Social Medicine, UCSF, San Francisco, California, USA

    J. T. Crane & P. Bourgois

  2. Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital, UCSF, San Francisco, California, USA

    A. Kawuma, J. H. Oyugi & D. R. Bangsberg

  3. Academic Alliance for AIDS Care and Prevention, Kampala, Uganda

    J. H. Oyugi, J. T. Byakika & D. R. Bangsberg

  4. Makerere University School of Medicine, Kampala, Uganda

    J. T. Byakika

  5. Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA

    A. Moss

  6. Positive Health Program, San Francisco General Hospital, UCSF, San Francisco, California, USA

    D. R. Bangsberg

  7. University of California at San Francisco, Epidemiology and Prevention Interventions Center, SFGH Building, 100 Room 301, PO Box 1347, San Francisco, California 94143, USA

    D. R. Bangsberg

Authors
  1. J. T. Crane
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  2. A. Kawuma
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  3. J. H. Oyugi
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  4. J. T. Byakika
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  5. A. Moss
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  6. P. Bourgois
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  7. D. R. Bangsberg
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Correspondence to D. R. Bangsberg.

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Crane, J.T., Kawuma, A., Oyugi, J.H. et al. The Price of Adherence: Qualitative Findings From HIV Positive Individuals Purchasing Fixed-Dose Combination Generic HIV Antiretroviral Therapy in Kampala, Uganda. AIDS Behav 10, 437–442 (2006). https://doi.org/10.1007/s10461-006-9080-z

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  • DOI: https://doi.org/10.1007/s10461-006-9080-z

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