Background:
A pilot community-based antiretroviral therapy (CBART) program in western Uganda was
previously shown to significantly improve quality of life outcomes among HIV patients in their
first year of treatment, though certain psychosocial challenges and issues remained. What is not
known is whether these issues diminish and if new issues arise with more time.
Objectives:
This study builds on previous research evaluating health-related quality of life outcomes of
patients in the CBART program. This study aimed to explore the physical and psychosocial
challenges faced by patients five to six years after the initiation of antiretroviral treatment.
Methods:
In-depth semi-structured interviews were conducted in Uganda in 2012 with 25 purposefully
selected CBART patients who had undetectable viral loads just prior to the interviews.
Interviews explored the topics of death and dying, hope, physical functioning, financial wellbeing,
stigma, social and family relations, sexual relations and childbearing in relation to HIV
infection and HIV treatment. Data were analyzed using thematic analysis.
Results:
Income had improved for all participants, compared with pre-treatment levels. As participants’
health improved and their strength returned, they felt a pressing need to establish and secure their
family’s future, while their health remained strong. However, given their baseline poverty and
the sale of assets to fund medical care, improvements were slow. Additionally, reduced strength
meant participants needed to look outside of subsistence farming alone to meet their financial
needs.