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dc.contributor.authorVenables, E
dc.contributor.authorTowriss, C
dc.contributor.authorRini, Z
dc.contributor.authorNxiba, X
dc.contributor.authorCassidy, T
dc.contributor.authorTutu, S
dc.contributor.authorGrimsrud, A
dc.contributor.authorMyer, L
dc.contributor.authorWilkinson, L
dc.date.accessioned2019-09-04T09:56:19Z
dc.date.available2019-09-04T09:56:19Z
dc.date.issued2019-06-20
dc.date.submitted2019-08-27
dc.identifier.issn1932-6203
dc.identifier.pmid31220116
dc.identifier.doi10.1371/journal.pone.0218340
dc.identifier.urihttp://hdl.handle.net/10144/619473
dc.description.abstractBACKGROUND: Globally, 37 million people are in need of lifelong antiretroviral treatment (ART). With the continual increase in the number of people living with HIV starting ART and the need for life-long retention and adherence, increasing attention is being paid to differentiated service delivery (DSD), such as adherence clubs. Adherence clubs are groups of 25-30 stable ART patients who meet five times per year at their clinic or a community location and are facilitated by a lay health-care worker who distributes pre-packed ART. This qualitative study explores patient experiences of clubs in two sites in Cape Town, South Africa. METHODS: A total of 144 participants took part in 11 focus group discussions (FGDs) and 56 in-depth interviews in the informal settlements of Khayelitsha and Gugulethu in Cape Town, South Africa. Participants included current club members, stable patients who had never joined a club and club members referred back to clinician-led facility-based standard care. FGDs and interviews were conducted in isiXhosa, translated and transcribed into English, entered into NVivo, coded and thematically analysed. RESULTS: The main themes were 1) understanding and knowledge of clubs; 2) understanding of and barriers to enrolment; 3) perceived benefits and 4) perceived disadvantages of the clubs. Participants viewed membership as an achievement and considered returning to clinician-led care a 'failure'. Moving between clubs and the clinic created frustration and broke down trust in the health-care system. CONCLUSIONS: Adherence clubs were appreciated by patients, particularly time-saving in relation to flexible ART collection. Improved patient understanding of enrolment processes, eligibility and referral criteria and the role of clinical oversight is essential for building relationships with health-care workers and trust in the health-care system.en_US
dc.language.isoenen_US
dc.publisherPublic Library of Scienceen_US
dc.rightsWith thanks to the Public Library of Science.en_US
dc.titlePatient experiences of ART adherence clubs in Khayelitsha and Gugulethu, Cape Town, South Africa: A qualitative study.en_US
dc.identifier.journalPLOS Oneen_US
dc.source.journaltitlePloS one
refterms.dateFOA2019-09-04T09:56:20Z


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