Factors influencing treatment default among patients initiated on antiretroviral at a district in the North West province of South Africa: A qualitative study

Abstract

Background: People living with HIV who default on antiretroviral therapy pose a significant global and local health challenge, and South Africa is not immune to this challenge.
Aim: This study explores factors influencing treatment default among patients receiving antiretroviral treatment in one district of North West province, South Africa. The study proffers recommendations to address default among patients initiated on anti-retroviral treatment.
Setting: A clinical setting in the North West province, South Africa.
Methods: A qualitative exploratory, descriptive and contextual research design was adopted. Purposive sampling was used to select potential participants. The population consisted of patients who defaulted on antiretroviral treatment and were registered at a specific primary healthcare facility. The sample size was determined by data saturation. Consequently, 12 participants who had defaulted on antiretroviral treatment for 3 months or more were interviewed. Data were collected through face to face, unstructured, in-depth individual interviews, field notes and an audio recorder. All ethical principles were followed throughout the study. Tesch’s method of analysis and open coding were employed to analyse the data.
Results: Patients default on antiretroviral treatment for various reasons, including a deficient healthcare system marked by overcrowding and negative staff attitudes. Personal issues, unemployment and life partners emerged as reasons for default.
Conclusion: Various factors influence the default on antiretroviral treatment, including access to healthcare facilities.
Contribution: This study adds new knowledge about best nursing practices for managing patients who default on antiretroviral treatment.