SETTING: We conducted a qualitative exploration into the palatability and acceptability of a novel fixed-dose combination (FDC) anti-tuberculosis drug. This study was nested in the SHINE (Shorter treatment for minimal TB in children) trial, which compares the safety and efficacy of treating non-severe drug-susceptible tuberculosis (TB) with a 6 vs. 4 months anti-tuberculosis regimen in children aged 0–16 years. Participants were recruited in Cape Town, South Africa.OBJECTIVE: To describe the palatability and acceptability of a FDC of rifampicin, isoniazid and pyrazinamide among South African children and their caregivers in the SHINE trial.METHODS: We conducted 20 clinic observations of treatment administration, during which we conducted 16 semi-structured interviews with children and their caregivers. Data were organised thematically to report on experiences with administering and ingesting the FDC.RESULTS: Children and caregivers' experiences varied from delight to disgust. In general, participants said that the FDC compared favourably to other formulations. Pragmatic challenges such as dissolving the FDC and the time required to administer the FDC impeded caregivers' ability to integrate treatment into their daily routines. Drug manipulation was common among caregivers to improve TB treatment administration.CONCLUSION: This novel FDC appears acceptable for children, albeit with practical challenges to administration. Scale-up of FDC use should include supplementary intervention components to support caregivers.

Reported barriers to HIV testing over the last 15 years have remained consistent, despite improved service offerings. We aimed to probe deeper by exploring how people who have never tested construct HIV testing in their talk. We used this to suggest underlying psychosocial barriers to testing even when there is high availability. We enrolled 14 participants who reported that they had never tested for HIV and conducted individual, open-ended interviews. The data were organised thematically with theory-generative interpretations informed by discourse analysis. Reasons for not testing reported reflect similar barriers identified in previous research. Deeper probing identified three discursive processes by which participants explained why they had never tested for HIV, suggesting that the way participants used ‘reasons’ in their talk is an indicator that the participants were repeating ‘tropes’. While aware of HIV testing facilities, participants still chose not to test. Influences on the choice to test or not were positioned as outside of the person’s control. These findings suggest that there are deeper reasons why some people have not tested and that these will not be resolved through merely increasing accessibility to testing services. We recommend increased consideration of the psychosocial implications of testing in service delivery.