Antiretroviral therapy for all

Abstract

Zambia has attempted to create universal access to antiretroviral therapy. However, barriers still remain at the individual, institutional and national levels to access ART. The objective of the study was to determine factors related to accessibility to ART by PLHIV in Chikuni Parish in Southern province of Zambia. Out of a total of 1,067 Chikuni Home Based Care clients, 182 filled in the questionnaire: 173 adults, 7 youth aged 15-25 years and 2 children below the age of 15 years. In addition, two local partners implementing HIV and AIDS-related programs were interviewed. Purposive sampling was used to select participants. Out of 182 respondents, 125 (67%) described their condition as of by then to be very good, 44 (24%) as good, and 9 (5%) as not too good. Appointments to collect ARVs were not kept as reported by 43% of the respondents. About a quarter (24%) reported that there was a shortage of ARVs. About 1 in 10 (9%) of the respondents did not take the medication regularly. Access to ART was rated as by 54% of the respondents as good and 45% rated it as fair. Two thirds of the respondents found it hard to reach the facility for treatment; reasons being hospital too far from home, transport too expensive and sometimes transport was not available. On the services received, 56% of the respondents were dissatisfied with the attention and quality of care they received. Challenges of under staffing and self-stigma were some of the barriers to accessing ART. About 1 in 10 (9%) of the respondents did not take the medication regularly. Decentralizing model for ART delivery would improve access to ART.