A qualitative assessment of barriers and facilitators to antiretroviral therapy adherence among human immunodeficiency virus patients in Jordan
More details
Hide details
Department of Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, JORDAN
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, JORDAN
Department of Maternal and Child Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, JORDAN
Forearms of Change Center to Enable Community, Amman, JORDAN
Publication date: 2022-07-25
Electron J Gen Med 2022;19(5):em395
To explore barriers and facilitators to antiretroviral therapy adherence among human immunodeficiency virus patients in Jordan from their perspectives.

Qualitative one-to-one interviews with HIV patients took place in a private support center that works on the inclusion of HIV patients in the society. The inclusion criteria for the study included patients who were currently receiving treatment for HIV for more than one year, has a Jordanian citizenship or residency, were at least 18 years old, and were physically and mentally competent to conduct a reliable, spoken interview.

The participants reported several barriers that negatively influenced their medication experience and adherence. These barriers included the following subthemes: accessibility, adverse reactions, financial burden, lack of support, medication manageability, psychological factors, and stigma. These facilitators included the following subthemes: benefits and QOL, fear, and support and additional services.

In summary, this is the first study in Jordan regarding HIV patients discuss the barriers and facilitator for ART adherence from their perspectives.

Weiss RA. Retrovirus classification and cell interactions. J Antimicrob Chemother. 1996;37(SUPPL. B):1-11. https://doi.org/10.1093/jac/37... PMid:8818825.
Heil EL, Banoub MF, Corbett AH. Human immunodeficiency virus infection. In: Chisholm-Burns MA, Schwinghammer TL, Malone PM, Kolesar JM, Lee KC, Bookstaver PB, editors. Pharmacotherapy principles and practice. New York, NY: McGraw-Hill Education; 2018.
UNAIDS. Fact sheet 2021 global HIV statistics. 2021. Available at: https://www.unaids.org/sites/d... (Accessed: 25 March 2022).
Philipp J. HIV/AIDS in Jordan and the work of FOCCEC. The Borgen Project. Available at: https://borgenproject.org/hiv-... (Accessed: 25 March 2022).
WHO. Who launches alliance to promote health development in MENA, Eastern Mediterranean. Jordan News Agency (Petra). Available at: https://petra.gov.jo/Include/I... (Accessed: 25 March 2022).
Fairall LR, Bachmann MO, Louwagie GMC, et al. Effectiveness of antiretroviral treatment in a South African program: A cohort study. Arch Intern Med. 2008;168(1):86-93. https://doi.org/10.1001/archin... PMid:18195200.
Montaner JS, Lima VD, Barrios R, et al. Association of highly active antiretroviral therapy coverage, population viral load, and yearly new HIV diagnoses in British Columbia, Canada: A population-based study. Lancet. 2010;376(9740):532-9. https://doi.org/10.1016/S0140-....
Bezabhe WM, Chalmers L, Bereznicki LR, Peterson GM. Adherence to antiretroviral therapy and virologic failure. Med (United States). 2016;95(15):1-9. https://doi.org/10.1097/MD.000... PMid:27082595 PMCid:PMC4839839.
Knobel H, Urbina O, González A, et al. Impact of different patterns of nonadherence on the outcome of highly active antiretroviral therapy in patients with long-term follow-up. HIV Med. 2009;10(6):364-9. https://doi.org/10.1111/j.1468... PMid:19490179.
Van Wijngaerden E, De Saar V, De Graeve V, et al. Nonadherence to highly active antiretroviral therapy: Clinically relevant patient categorization based on electronic event monitoring. AIDS Res Hum Retroviruses. 2002;18(5):327-30. https://doi.org/10.1089/088922... PMid:11897033.
Liu H, Miller LG, Hays RD, et al. Repeated measures longitudinal analyses of HIV virologic response as a function of percent adherence, dose timing, genotypic sensitivity, and other factors. J Acquir Immune Defic Syndr. 2006;41(3):315-22. https://doi.org/10.1097/01.qai... PMid:16540932.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493-505. https://doi.org/10.1056/NEJMoa... PMid:21767103 PMCid:PMC3200068.
Martin F, Lee J, Thomson E, Tarrant N, Hale A, Lacey CJ. Two cases of possible transmitted drug-resistant HIV: Likely HIV superinfection and unmasking of pre-existing resistance. Int J Std AIDS. 2016;27(1):66-9. https://doi.org/10.1177/095646... PMid:25663247 PMCid:PMC4674743.
Hosseini Z, Eftkhar H, Nedjat S, et al. Adherence to HIV/AIDS antiretroviral therapy among drug users: A qualitative study in Iran. Iran J Nurs Midwifery Res. 2016;21(1):29-37. https://doi.org/10.4103/1735-9... PMid:26985220 PMCid:PMC4776558.
Bezabhe WM, Chalmers L, Bereznicki LR, Peterson GM, Bimirew MA, Kassie DM. Barriers and facilitators of adherence to antiretroviral drug therapy and retention in care among adult HIV-positive patients: A qualitative study from Ethiopia. PLoS One. 2014;9(5):e97353. https://doi.org/10.1371/journa... PMid:24828585 PMCid:PMC4020856.
Engelbrecht JG, Mukinda FK, Green B, Skinner D. How clinicians experience a simulated antiretroviral therapy adherence exercise: A qualitative study. African J Prim Heal care Fam Med. 2018;10(1):1-7. https://doi.org/10.4102/phcfm.... PMid:30456973 PMCid:PMC6244187.
Kerse N, Buetow S, Mainous AG, Young G, Coster G, Arroll B. Physician-patient relationship and medication compliance: A primary care investigation. Ann Fam Med. 2004;2(5):455-61. https://doi.org/10.1370/afm.13... PMid:15506581 PMCid:PMC1466710.
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-43. https://doi.org/10.1093/ajhp/4....
Wasti SP, Simkhada P, Randall J, Freeman J V, Teijlingen E Van. Factors influencing adherence to antiretroviral treatment in Nepal : A mixed-methods study. PloS One. 2012;7(5):1-11. https://doi.org/10.1371/journa... PMid:22563464 PMCid:PMC3341373.
Adeneye AK, Adewole TA, Musa AZ, Onwujekwe D, Odunukwe NN, Araoyinbo ID. Limitations to access and use of antiretroviral therapy (ART) among HIV positive persons in Lagos , Nigeria. World Health Popul. 2006;8(2):46-56. https://doi.org/10.12927/whp.2... PMid:18277101.
Bennett CL, Wolf MS. Social stigma concerns and HIV medication adherence. AIDS Patient Care STDS. 2006;20(5):359-68. https://doi.org/10.1089/apc.20... PMid:16706710.
Karutu CK. Understanding the barriers and facilitators to the retention of HIV positive women along the prevention of mother-to-child transmission of HIV (PMTCT) continuum in Kenya. Boston University. 2016:290.
Kebaabetswe PM. Barriers to participation in the prevention of mother-to-child HIV transmission program in Gaborone, Botswana: A qualitative approach. AIDS Care. 2007;19(3):355-60. https://doi.org/10.1080/095401... PMid:17453569.
Rosenberg NE, Gross R, Mtande T, et al. “We have heard it together”: A qualitative analysis of couple HIV testing and counselling recruitment in Malawi’s option B+ programme. Afr J AIDS Res. 2017;16(3):215-23. https://doi.org/10.2989/160859... PMid:28978289 PMCid:PMC6103295.
Puttkammer N, Domerçant JW, Adler M, et al. ART attrition and risk factors among option B+ patients in Haiti: A retrospective cohort study. PLoS One. 2017;12(3): e0173123. https://doi.org/10.1371/journa... PMid:28264045 PMCid:PMC5338795.
Nachega JB, Skinner D, Jennings L, et al. Acceptability and feasibility of mHealth and community-based directly observed antiretroviral therapy to prevent mother-to-child HIV transmission in South African pregnant women under option B+: An exploratory study. Patient Prefer Adherence. 2016;10:683-90. https://doi.org/10.2147/PPA.S1... PMid:27175068 PMCid:PMC4854240.
Ozer TT, Yula E, Deveci O, Yanik K, Durmaz S, Tekin A. Evaluation of the screening test results before marriage. J Clin Exp Invest. 2011;2(3):292-4. https://doi.org/10.5799/ahinjs....
Uzun BK, Er H, Gungor S, Pektas B, Demirci M. Seropositivity of HBsAg, anti-HCV and anti-HIV in preoperative patients. J Clin Exp Invest. 2013;4(4):449-52. https://doi.org/10.5799/ahinjs....
Kucukzeybek BB, Calli AO, Uyaroglu MA, et al. CD3 Positive gastric plasmablastic lymphoma in A HIV negative patient: A case report. J Clin Exp Invest. 2017;8(1):28-30. https://doi.org/10.5799/jcei.3....
Ozlu T, Tas T, Mengeloglu FZ, Kocoglu E, Donmez ME. Frequency of HBsAg, anti-HCV, and anti-HIV in pregnant women and/or patients with gynecologic diseases in a tertiary hospital. J Clin Exp Invest. 2013;4(2):166-70. https://doi.org/10.5799/ahinjs....
Journals System - logo
Scroll to top