Exploring barriers and enablers to ARV treatment adherence for men who have sex with men

Abstract

The amount of research that examines adherence to antiretroviral treatment is now immeasurable. However, research on understanding the subjective experiences of men who have sex with men (MSM) and living with HIV while taking antiretroviral therapy remains limited. This research uses a qualitative methodology, using semi-structured interviews, carried out on nine participants who frequently use a Johannesburg support group aimed at MSM living with HIV. The time period of these men living with HIV and taking antiretroviral therapy varied from a number of months to many years. The interviews were audio-recorded and transcribed. In terms of analysis, thematic content analysis was used identified the enablers and barriers to treatment adherence. These were broken into biopsychosocial factors with the main outcomes of this research suggesting that adherence is complex and influences are far beyond just biological. The majority of the elements raised by the participants indicate the significance of psychological and social factors. This makes the development of adherence interventions aimed at MSMs more detailed than simply following medical provider directions. There appeared to be consensus that although some participants of this research would prefer to not take antiretroviral therapy because of the side-effects, the alternative for them was something that they wanted to consider, such as illness and death. The belief that the medication is keeping them healthy, improving quality of life and allowing them to focus on day-to-day living seemed to dominate over the psychological effects of the condition or the medication in terms of adherence. Because of the way that HIV is perceived within society, the threat of discrimination is real and for many of the participants shape the way they see themselves, the world and this in turn guides their thinking when it comes to issues, especially with disclosure. Above all, this research explores the antiretroviral adherence factors specifically associated to MSM.