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ORIGINAL RESEARCH article

Front. Health Serv.
Sec. Implementation Science
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1387823

Perspectives of health workers on the facilitators and barriers to antiretroviral therapy adherence following intensive adherence counselling in Northern Uganda Authors

Provisionally accepted
Humphrey Beja Humphrey Beja *Daisy Nakayiwa Daisy Nakayiwa Innocent Ocitti Owachgiu Innocent Ocitti Owachgiu Micheal Tonny Edek Micheal Tonny Edek Veronic Kobusinge Veronic Kobusinge Oscar Akaki Oscar Akaki Samson Udho Samson Udho
  • Lira University, Lira, Uganda

The final, formatted version of the article will be published soon.

    In some contexts, People Living with HIV (PLWH) who are virally non-suppressed and on Intensive adherence counseling (IAC) program have demonstrated non-adherence to ART even after IAC. There is limited literature on the facilitators and barriers to ART adherence following IAC.The study aimed at exploring the perspectives of healthcare workers on the facilitators and barriers to ART adherence following IAC among PLWH in Northern Uganda.This was a descriptive qualitative study conducted among healthcare-workers working in the ART clinics of the two most high-volume public health facilities in Lira District. We purposively sampled 15 study participants and performed face to face in-depth interviews (IDI) using the IDI guide formulated based on the components of the Behavior, Capability, Motivation and Opportunity (COM-B) framework for behavior change. Thematic analysis was used based on the components of the COM-B framework. In this study, the desired behavior was ART adherence following IAC, a factor that had was perceived to have positive effect on any of the components of the COM-B framework was classified as a facilitator and those that were perceived to negatively affected any of the components of the COM-B framework were classified as barriers.Results: Majority of the participants were females (53%), diploma holders (40%), and nurses (40%). The perceived facilitators and barriers to ART adherence following IAC emerged into six key themes under the sub-divisions of the three domains of the COM-B framework. They are: Cognitive and emotional processes, physical and practical skills, accessibility and material resources, social relationships and cultural dynamics, cognitive beliefs and aspirations, and finally, emotional and subconscious drivers. These themes are facilitators and barriers to ART adherence following IAC depending on the lenses of interpretation.

    Keywords: Facilitators, barriers, antiretroviral therapy, Intensive adherence counselling, Healthcare-workers

    Received: 18 Feb 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Beja, Nakayiwa, Owachgiu, Edek, Kobusinge, Akaki and Udho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Humphrey Beja, Lira University, Lira, Uganda

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.