Antiretroviral Therapy in Egypt: Are There Any Barriers to Medication Adherence?

Abstract

Background: Egypt provides free antiretroviral therapy (ART) to some 5000 Egyptian People Living with HIV/AIDS (PLWHA) across a number of distribution points. Objective: This study aimed mainly at identifying potential facilitators and barriers to ART. Method: Focus groups discussions (FGDs) were conducted with 33 PLWHA representing most of Egyptian geographical areas. Discussions were designed to cover socio-demographic characteristics of participants, routine investigations, monitoring & follow up measures, problems associated with drug intake, PLWHA needs, stigma, and relevant future concerns. Results: Participants confirmed availability of drugs without interruptions almost all months, yet, for the majority (63.7%) of participants, investigations were done during the process of tracing their clinical complaints that were behind first HIV testing, while treatment was initiated without prior relevant investigations for (36.4%) of participants. The majority (75.75%) of participants did not receive adequate counseling before starting their treatment. Almost two thirds (63.6%) of participants initiated drugs at late stage of the disease. All participants (100.0%) expressed their needs for a well-trained person at each center. The treatment had troublesome side effects in the form of drowsiness and loss of concentration among (72.72%) of participants. All (100%) of participants mentioned different stigmatizing practices against them at treatment facilities. Conclusion: Lack of accurate information about HIV and ART, inadequate Monitoring and follow up measures, drug side effects and stigmatizing practices against Egyptian PLWHA represent the most common barriers to ARV therapy.