A Qualitative Study on the Burden of Nonadherence to Antiretroviral Therapy Among People Living With HIV/AIDS in Jharkhand, India.

Background: Adherence to antiretroviral therapy (ART) is the most important factor in the management of human immunodeficiency virus (HIV). This study examines the level of nonadherence to ART and the predictors of interventions to improve ART adherence in Jharkhand, a state with a predominance of tribes.

Methods: The present study was conducted at the ART center, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand. As it represents most patients from the state and was easily accessible to us, this center was taken as the study site. Considering ART intake, 30 tribal and 30 non-tribal patients were selected. All patients' baseline data was taken from the center and follow-up visits were done at their homes. Information regarding sociodemographic profile, ART regimen, adherence to ART, and reasons for nonadherence was collected. The interviews were recorded on audiotape, transcribed, and translated verbatim. We used a thematic approach to analyze the data.

Results: In our study, the prevalence of ART at the RIMS ART center was 21.7%, and the causes of non-adherence were asked in depth. The most common reason for nonadherence to treatment was the traveling distance and cost incurred in travel.

Conclusion: Comprehensive research can provide valuable insights into the reasons behind nonadherence and help develop targeted interventions to promote adherence. Some incentives can be provided along with treatment to cover long-distance travel expenses and loss of wages. Delivery of drugs to ART centers can be more regularized.