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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- Crane, J.T., Kawuma, A., Oyugi, J.H. et al. AIDS Behav (2006) 10: 437. doi:10.1007/s10461-006-9080-z
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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.