Medication beliefs among people living with HIV taking antiretroviral treatment in Zimbabwe: a qualitative study

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Background The beliefs that patients hold about their medicines are known to influence treatment adherence. This study’s objective was to explore and identify specific antiretroviral (ART) beliefs from human immunodeficiency virus (HIV) positive patients in Zimbabwe. Methods In-depth qualitative interviews were conducted with 21 (female = 9; 42.9%) purposively sampled HIV-positive adults attending an urban HIV clinic. All participants had been prescribed ART for at least one month. Two additional key informant interviews were conducted with healthcare professionals. Data were analysed inductively using grounded theory framework. Results Participants’ beliefs about ART were grouped into two themes: perceived importance, and concerns about ART. The majority of participants viewed ART as necessary for staying alive and healthy. Participants who had attempted alternative treatments experienced health deterioration and subsequently returned to using ART. There were several medication concerns, including: the short- and long-term effects of the medication; the number of doses; potential interactions with other medications; and fear of stigma. However, the more necessary ART was perceived to be, the less these concerns affected self-reported adherence behaviour. Conclusions Healthcare professionals need to be aware of these beliefs so they can provide tailored, adequate adherence support. Further research is needed to explore whether reducing concerns and enhancing necessity beliefs improve adherence in this population.

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