AIDS and Behavior

, Volume 10, Issue 4, pp 437–442

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

  • J. T. Crane
  • A. Kawuma
  • J. H. Oyugi
  • J. T. Byakika
  • A. Moss
  • P. Bourgois
  • D. R. Bangsberg
Original Paper

DOI: 10.1007/s10461-006-9080-z

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

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.

Key Words

adherence HIV generic fixed-dose combination antiretroviral therapy Africa ethnography 

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • J. T. Crane
    • 1
  • A. Kawuma
    • 2
  • J. H. Oyugi
    • 2
    • 3
  • J. T. Byakika
    • 3
    • 4
  • A. Moss
    • 5
  • P. Bourgois
    • 1
  • D. R. Bangsberg
    • 2
    • 3
    • 6
    • 7
  1. 1.Department of Anthropology, History and Social MedicineUCSFSan FranciscoUSA
  2. 2.Epidemiology and Prevention Interventions Center, Division of Infectious DiseasesSan Francisco General Hospital, UCSFSan FranciscoUSA
  3. 3.Academic Alliance for AIDS Care and PreventionKampalaUganda
  4. 4.Makerere University School of MedicineKampalaUganda
  5. 5.Department of Epidemiology and BiostatisticsUCSFSan FranciscoUSA
  6. 6.Positive Health ProgramSan Francisco General Hospital, UCSFSan FranciscoUSA
  7. 7.University of California at San Francisco, Epidemiology and Prevention Interventions CenterSan FranciscoUSA