Patient-related factors
In this overarching theme, participants reported factors related to their own self-motivation and self-efficacy that ultimately describe their compliance to ART. These factors included the following three sub-themes: psychological reactions, family and friends, and routines & reminders.
Psychological reactions : Participants reported a wide range of emotions that positively or negatively affected their compliance to ART. Stigmatization was frequently mentioned by participants as a factor that negatively affected their compliance as they avoid taking their medications in front of others. The fear of being judged by others led some participants to hide their medications and only take their medication when they were alone.
In one extreme case, participant reported that HIV patients can fear for their own lives if they were ever caught taking ART. However, fear was not always an emotion that negatively influences compliance. Some participants reported that their fear of transmitting the disease to others was a motivator for a better compliance.
Participants also reported positive emotions that contributed to their ART compliance. Self-confidence was among these emotions. Some participants reported that their self-confidence positively influenced their coexistence with HIV infection, and the willingness to be strong which ultimately increased their adherence to ART. Participants’ self-consciousness of their well-being also motivated them to regularly take their medications. One participant expressed his happiness for being HIV positive because he became more interested in taking care of himself and his own health.
Family and friends: Getting support from family or friends motivated participants to regularly take their medications. Families’ support was not limited to reminding participant to take their medications, it also influenced participants’ compliance to follow up visits to their physicians and lab tests. Children were another source of motivation for participants who have children. Participants with children reported they are always thinking about their children and their constantly remind themselves that they have to live longer to be there for their children. Two participants were concerned about transmitting the infection to their children if they did not adhere to therapy.
Despite that some participants did not inform their families about their infection, some chose to share it with their friends. Friends support appeared to influence participants’ attitudes toward their infection and ultimately their compliance to therapy.
Routines & reminders : A few participants reported that they rely on a daily routine to remind themselves to take their medications. Another participant reported. Other participants chose to put their medication in a place where it is always checked or use a phone alarm.