Despite South Africa’s progress in expanding access to antiretroviral therapy (ART), retaining people living with HIV (hereafter referred to as patients) in care remains a major challenge. Retention is essential for achieving viral suppression and preventing onward HIV transmission.
This study aimed to explore the perceptions and experiences of patients and healthcare providers regarding factors influencing retention in care during the first 12 months of ART.
A qualitative exploratory design was used at Kanyamazane Community Health Centre (CHC), a primary healthcare facility in Mpumalanga province, South Africa. Semi-structured interviews were conducted with 12 patients and four healthcare providers, purposively sampled to include those consistently retained and those re-engaged after loss to follow-up. Data were transcribed verbatim and analysed thematically using Braun and Clarke’s framework with ATLAS.ti. Trustworthiness was ensured through member-checking and triangulation.
Six key themes were identified: (1) social and clinical support, (2) health education and empowerment, (3) motivation, (4) geographical and financial constraints, (5) stigma and disclosure challenges and (6) health system-related barriers. Facilitators of retention included family support, peer groups and differentiated service delivery models. Barriers included long waiting times, staff shortages and inadequate follow-up systems. Participants recommended structured appointment systems and personalised case management.
Retention in HIV care is influenced by an interplay of individual, social and health system factors. Holistic, person-centred interventions are needed to promote early and sustained engagement in care.
This study demonstrates that early retention in HIV care is strengthened by family involvement, peer support, continuous counselling and home-based care, while barriers such as stigma, long clinic waiting times and poor tracing systems persist. It provides actionable strategies including structured booking systems and tailored case management to improve retention.
HIV and AIDS remains a major public health problem,
While there is no standard definition of retention in care, according to Mukumbang et al.
As access and availability of ART increased, there are multiple challenges to retention in care.
The needs beyond medical care are not addressed by healthcare providers.
This study employed a qualitative exploratory research design to explore the perceptions and experiences of healthcare providers and patients regarding retention in care during the first 12 months of treatment. Exploratory research is carried to investigate an undefined problem by exploring the research topic in varying depths rather than providing final and conclusive answers to research questions.
The Kanyamazane CHC is a primary healthcare facility located in a semi-urban area within the Ehlanzeni District of Mpumalanga province, South Africa. The district falls under the City of Mbombela Local Municipality and serves a diverse population with a high HIV burden.
Purposive sampling was used to recruit participants with relevant experience and perspectives on retention in HIV care.
Inclusion criteria encompassed all genders, aged 18 years and older, who had initiated ART at Kanyamazane CHC, including those who had experienced LTFU within the past 12 months and were re-engaged into care. Eligible healthcare providers were actively involved in managing patients and implementing retention interventions.
Exclusion criteria included individuals who had initiated ART on the day of the interview, those on ART initiated elsewhere and transferred in and those below 18 years.
Healthcare providers were identified through collaboration with the facility manager to ensure inclusion across different staff cadres. Patients were referred by healthcare providers during routine consultations. Referrals were conducted in a private consultation room to uphold confidentiality. This environment enabled S.S. to provide detailed information about the study, address any participant concerns and obtain informed consent while maintaining privacy and dignity.
To enhance the quality of data collection and participants’ understanding, three actual interviews – two for patients and one for healthcare providers – were conducted to pre-test the interview guides. After the interviews, all questions were found relevant for gathering the required information and understandable to participants. At the commencement of interviews, eligible participants were screened by S.S. following referral. After obtaining informed consent, one-on-one interviews were conducted using semi-structured interview guides (see
Transcription was carried out verbatim from audio-recorded in-depth interviews to ensure that the participants’ responses were accurately captured in their own words, preserving the nuances and contextual meanings essential for qualitative analysis. Each recording was transcribed by S.S., who was familiar with the study objectives and subsequently reviewed by S.N. for accuracy and completeness. This approach aligns with best practices in qualitative research, which emphasise the importance of faithful transcription to maintain the integrity of the data.
The thematic analysis followed the six-phase approach outlined by Braun and Clarke. Phase 1 involved becoming familiar with the data: a process that began during data collection and continued through the transcription of interviews. S.S. read through all transcripts multiple times to gain a comprehensive understanding of the dataset. As this process unfolded, emerging ideas, patterns and meanings gradually took shape. Phases 2 and 3 focused on generating initial codes and building a coding framework. Once a broad understanding of the data was established, a project was created using ATLAS.ti (Scientific Software Development GmbH, Berlin, Germany), where all transcripts were uploaded. The software automatically assigned numbers to each document based on the upload order. S.S. then conducted initial coding by identifying codes, categories and patterns across the transcripts. This step aimed to label significant words and phrases used by participants. In Phase 4, the search for themes began by exploring the codes specifically related to issues surrounding retention or non-retention in HIV care. Phase 5 involved reviewing and refining these codes, grouping recurring patterns into meaningful categories that contributed to the formation of overarching themes. Finally, in Phase 6, the themes were clearly defined and named, with key insights identified and briefly described to capture the essence of each theme.
To enhance the rigour and trustworthiness of the findings, member-checking and triangulation techniques were applied. Often regarded as the gold standard of qualitative research, member-checking was used to obtain feedback from the participants about one’s interpretations.
Ethical clearance was obtained from the Faculty of Health Sciences Research Ethics Committee at the University of Pretoria (Reference No: 651/2024) and from the Mpumalanga Department of Health via the National Health Research Database (NHRD) (Reference No: MP_202410_014). All participants provided written informed consent for participation and audio recording. To protect confidentiality, healthcare providers were identified using the prefix ‘H’ and patients with the prefix ‘P’ in all transcripts and reporting.
A total of four healthcare providers and 12 patients participated in the study (
A summary of participant characteristics (healthcare providers and patients).
| Characteristics | Healthcare providers ( |
Patients ( |
||
|---|---|---|---|---|
| % | % | |||
| Female | 4 | 100 | 6 | 50 |
| Male | - | - | 6 | 50 |
| Mean age | 44 | - | 40 | - |
| Age range | 33–60 | - | 23–54 | - |
| Mean years of experience | 11 | - | - | - |
| Range | 5–21 | - | - | - |
| Professional nurse | 2 | 50 | - | - |
| Pharmacy assistant | 1 | 25 | - | - |
| HIV lay counsellor | 1 | 25 | - | - |
| Employed | - | - | 6 | 50 |
| Self-employed | - | - | 3 | 25 |
| Unemployed | - | - | 3 | - |
| Diploma | 3 | 75 | - | - |
| Matric or secondary | 1 | 25 | 12 | 100 |
| Previously LTFU | - | - | 5 | 42 |
| No history of LTFU | - | - | 7 | 58 |
LTFU, lost to follow-up.
The following section presents findings from in-depth interviews conducted. The analysis yielded six overarching themes that reflect the complex interplay of individual, interpersonal and structural factors influencing retention to HIV care during the first 12 months of treatment (
Summary of themes, subthemes and key insights.
| Themes | Subthemes | Key insights |
|---|---|---|
| Family support | Family members provided daily reminders, emotional encouragement and helped normalise treatment. | |
| Peer-to-peer support | Group sessions helped reduce stigma, increased shared learning and built community resilience. | |
| Home-based care | Home visits and community follow-up encouraged re-engagement and provided essential support. | |
| Counselling at initiation builds understanding | Early counselling helped patients understand ART; initiation build by reducing fear and building confidence. | |
| Healthcare provider encouragement | Respectful, non-judgemental counselling helped patients accept their diagnosis and builds trust. | |
| Empowerment through continuous engagement | Ongoing messages about adherence empower patients to take control of their health. | |
| Health education translates into personal responsibility | Patients embraced lifelong treatment and incorporated it into daily routines. | |
| Gaps and missed opportunities | Some felt education lacked depth or personal opportunities relevance, limiting its impact. | |
| Staying alive for family | Desire to raise and support children drove adherence and resilience. | |
| Acceptance of HIV status | Accepting one’s status gave patient emotional clarity, and the status strengthened their engagement in care. | |
| Learning from others’ mistakes | Observing others who defaulted and became ill or died reinforced commitment to treatment adherence. | |
| Relocation without transfer and work commitments | Mobility because of work without proper transfer letters disrupted continuity of treatment. | |
| Poverty and securing income | Unemployment, food insecurity and income security competed with the need for treatment. | |
| Solutions through decentralisation and community support | Decentralised medication collection (e.g. CCMDD) and home follow-up supported adherence. | |
| Fear of being seen or judged | Fear of being recognised at the clinic led to the avoidance of care to prevent community gossip or judgement. | |
| Taking medication secretly | Hiding medication use at home because of non-disclosure disrupted treatment inconsistency. | |
| Lack of support and self-stigma | Rejection at home and internalised shame caused emotional distress and reduced motivation to remain in care. | |
| Solutions through support groups | HIV support groups help overcome barriers for patient. | |
| Long waiting hours | Clinic delays and inefficiencies frustrated patients and discouraged consistent follow-up. | |
| Staff shortages | Inadequate staffing reduced service quality and delayed care provision. | |
| Negative communication | Insensitive language from healthcare providers created fear and pushed patients away from care. | |
| Inconsistent tracing | Follow-up systems were not always reliable because of incorrect contact details or staff workload. | |
| Solutions through patient booking and case management | Improving patient flow and personalised support addresses clinical and non-clinical factors. |
ART, antiretroviral therapy; CCMDD, Central Chronic Medicine Dispensing and Distribution.
Participants in this study frequently highlighted the importance of both social and clinical support in helping them stay engaged with HIV treatment. Family, support groups and home-based carers all played roles in providing encouragement, reminders and emotional strength. These support systems often made the difference between defaulting and remaining on treatment.
Some participants shared that their family was actively involved in their care, especially by reminding them to take their medication:
‘I am happy because even at home, I did not hide my status. My children know that I am taking ARVs [
Support within the home, particularly when disclosure was possible, created an environment of shared responsibility and mutual care.
A few participants described how support groups helped them feel less isolated and more hopeful:
‘There was a certain support group where we were told everything to make us not to feel like we are the only ones affected by HIV.’ (P1, male, 40 years old)
‘When I start treatment, there were support groups where they encouraged people to adhere to their treatment.’ (P11, male, 51 years old)
This form of peer support helped to normalise the experience of living with HIV and offered an emotional lifeline for those struggling with stigma or acceptance.
Home-based care teams were also important sources of motivation and helped patients return to care after defaulting:
‘I had a neighbour [
‘They were also home-based care team who used to visit us and encouraged people to adhere to treatment.’ (P11, male, 51 years old)
‘We have seen people coming back due to the work done by our WBOT team and health promoter.’ (H1, female, HIV lay counsellor)
These visits provided both health education and encouragement, especially for patients who had disengaged from care.
Participants in this study described how health education and counselling empowered them to understand their diagnosis, adhere to treatment and take responsibility for their health. For many, this knowledge transformed fear into action and confusion into clarity.
The initial counselling experience helped patients accept their status and begin ART with purpose:
‘When I started on ART, they trained me for 3 days on the importance of treatment adherence.’ (P6, female, 54 years old)
‘They spoke to me about the importance of treatment adherence and the consequences of non-adherence.’ (P8, female, 38 years old)
These early education sessions helped calm fears, correct misconceptions and prepare participants for the reality of lifelong treatment.
Clinical staff were often praised for their role in motivating patients, especially during times of fear or doubt:
‘We then encourage them to adhere on treatment since they are now on chronic like those who are diabetic.’ (H1, female, HIV lay counsellor)
‘The counselling from the sister encouraged me to accept my status … I was traumatised as I also thought I am going to die.’ (P8, female, 38 years old)
The way healthcare workers spoke to patients had a direct impact on their willingness to stay in care. Encouraging and non-judgemental communication was especially powerful.
For others, repeated messages about adherence and the benefits of staying on treatment reinforced their commitment:
‘They talk to you in such a way that you will understand. Especially to us [
‘As I come to collect treatment, they ask how I feel and I tell them how I feel.’ (P6, female, 54 years old)
‘Our counselling start when the person test for HIV. When the person test positive, our counselling becomes continuous when the patient is on treatment.’ (H4, female, professional nurse)
Some participants internalised the messages and took full ownership of their health:
‘Yes, it is helpful because I am able to take care of my life. I come to the clinic on my given date and take my pill at the same time every day.’ (P3, female, 33 years old)
‘I don’t take it as a treatment. I count it as if I am taking my daily food.’ (P6, female, 54 years old)
‘I stay on treatment because this is my life. If I stop taking the treatment, I will be ill as the disease will start again.’ (P12, male, 36 years old)
These quotes show how patient empowerment is not only about clinical facts – it is also about feeling seen, respected and supported in a human way.
However, others felt the information was not always enough or not delivered in a way that helped them cope with their realities:
‘It helps to those who listen when they talk to them. We are different as people. Other people hold to what they were told but others doesn’t as we also see them not honouring their appointment dates.’ (P8, female, 38 years old)
‘According to my opinion, it is not helpful … Sometimes they don’t emphasise on the impacts of defaulting treatment.’ (P9, male, 45 years old)
This highlights the importance of not only delivering health information but also doing so in a way that is tailored to patients’ understanding, emotional readiness and social context.
While many patients at Kanyamazane CHC faced stigma, long queues and financial stress, a strong theme emerged around self-motivation and personal responsibility. Several participants spoke about why they continued to take ART without being reminded or followed up. For them, staying alive, protecting their children or accepting their status became powerful reasons to adhere. Their stories reflect resilience, self-awareness and hope important elements of patient agency.
For many participants, the desire to stay alive for their children and loved ones was a key motivator:
‘Eish, I am thinking about my kids. If I don’t adhere to my treatment and die, who will raise them? I try because I want to live for them, my wife and my family.’ (P1, male, 40 years old)
‘I am a mother of two. I have no parents. I don’t see any reason for me to stop taking treatment because I have children to raise. I want to see them growing.’ (P7, female, 34 years old)
These expressions of hope and responsibility reveal how deeply family relationships motivate patients to stay healthy.
Several participants described their treatment as a personal responsibility – something they do for themselves, without being pushed:
‘Is up to a person. The clinic is there to help you with the treatment. It up to you to take treatment accordingly.’ (P4, male, 42 years old)
‘I don’t take it as a treatment. I count it as if I am taking my daily food.’ (P6, female, 54 years old)
This level of acceptance and internal motivation shows how some patients become active agents in their own health – rather than passive recipients of care.
Coming to terms with an HIV diagnosis played a major role in empowering patients to take control of their health journey:
‘I think they helped me a lot to understand what is going on, until I accepted to move forward.’ (P1, male, 40 years old)
‘It has helped me to accept my status and adhere to my treatment.’ (P2, female, 23 years old)
Once acceptance was achieved, participants found it easier to adhere to treatment.
Some participants were motivated by what they saw happen to others who had stopped taking treatment:
‘They will tell you about the people who have died because of non-adherence. You end up telling yourself that I don’t want to die and leave my two children behind.’ (P10, female, 34 years old)
This external observation became an internal motivator – shaping future behaviour based on past lessons.
Geographical access and transport-related challenges significantly impact retention to HIV care. For patients at Kanyamazane CHC, difficulties include costs associated with traveling when relocating for work and meeting basic needs such as food. These challenges were not always about the physical distance to the clinic – but about the broader constraints of time, money and daily survival.
Participants who moved or worked far from the clinic struggled to maintain care because of delays in obtaining transfer letters or a lack of familiarity with new facilities:
‘I was working in Jozi. So I thought I would get time to come and request a transfer letter but I didn’t … I should have just reported to any clinic in Jo’burg and asked for help.’ (P5, male, 46 years old)
In some cases, patients remained unlinked to care for extended periods because of work commitments, prioritising time for work rather than at the clinic:
‘Also with the fact that I am working with people at work, I have to be always at work.’ (P7, female, 34 years old)
‘I have to attend trainings at work. So, I end up missing my appointment dates.’ (P10, female, 34 years old)
For unemployed patients, treatment adherence often competed with basic needs such as food:
‘Hence, I always tell my family to help me with food since I am unemployed, so I will be able to continue with my treatment.’ (P5, male, 46 years old)
‘I was struggling with hunger sometimes … I realised that the pills will hurt me since I was not working, and they had told me that I should never take them on an empty stomach.’ (P8, female, 38 years old)
For working patients, attending appointments often meant losing a day’s wages or having to explain absences to employers:
‘For me to attend clinic I have to report at work, I have to produce a doctor’s note to show that I was at the clinic.’ (P7, female, 34 years old)
These quotes reflected the social and financial constraints that affected clinic attendance and treatment adherence among patients.
Decentralised models such as Central Chronic Medicine Dispensing and Distribution (CCMDD) were highlighted as helpful, especially for working participants:
‘I accepted [
‘Others choose their pick-up points next to their working environments.’ (H3, female, professional nurse)
Community-based follow-up was also seen as effective for reaching those who missed appointments:
‘They will come to your house to make sure what is happening about you.’ (P7, female, 34 years old)
For many patients, stigma and difficulties around disclosure continue to affect how they engage with care. Participants in this study described how fear of being judged, hiding their treatment and rejection by family members made it hard to stay on ART. Some even defaulted from care because of these pressures. Their voices offer a deeper understanding of how social and emotional experiences shape retention to treatment.
Fear of being seen at the clinic and being identified as someone living with HIV led some patients to stop attending altogether:
‘People have fear of other people, like asking themselves who am I going to meet at the clinic? Just because they don’t want the local people to see them that they are taking treatment, they end up stop taking their treatment.’ (P7, female, 34 years old)
Others feared how they would be treated if their status became public:
‘They are afraid of people on what they will say. How they will talk about their status.’ (P1, male, 40 years old)
Disclosure within the home was not always possible. Some participants had to hide their medication, which made adherence difficult:
‘Other people take the treatment in secret. No one knows at home … when there are people or visitors at home, this person will not be able to take the pill even the rest of the week.’ (P11, male, 51 years old)
‘But we have patients who are not collecting their treatment because they were away and no one came to collect for them. They haven’t told anyone about their treatment.’ (H2, female, pharmacy assistant)
Stigma also appeared in the form of rejection at home or internalised guilt and shame:
‘Others give up on treatment because they lack support at home. They are being excluded from family matters because of their HIV status.’ (P6, female, 54 years old)
‘I was having a problem because I never thought I will be infected by this virus.’ (P9, male, 45 years old)
At the start of the study, there were no longer any support groups. Patients proposed their reestablishment, especially the male patients, which highlighted gender-specific preference in HIV care:
‘It is better if we can have support groups back.’ (P1, male, 40 years old)
‘If they can have another groups of people who will check the patient files and track how the patients are doing in terms of viral load suppression and check how these people are doing.’ (P11, male, 51 years old)
While many participants in this study appreciated the services offered at Kanyamazane CHC, they also described several challenges within the health system affecting their ability to stay in care. These included staff shortages, long waiting times, inconsistent follow-up systems and negative staff attitudes. These barriers created frustration, fear and, at times, caused people to delay or stop treatment.
A recurring issue was the long time spent at the clinic – especially difficult for those who work or are unwell:
‘In most cases you can arrive at the clinic at 7am and stay until 3pm to get attended.’ (P7, female, 34 years old)
‘The challenge will happen when we spend time waiting for assistance in the clinic.’ (P12, male, 36 years old)
Long waiting times also discouraged some from returning or caused them to miss appointments.
Some participants described how limited staff made it hard for the clinic to function efficiently, affecting the quality of care:
‘The clinic has a shortage of staff which makes it difficult for the one working to do their tasks well.’ (P9, male, 45 years old)
This affected follow-ups, patient communication and the ability to provide individualised care. While some patients felt neglected:
‘A sister can go to lunch without anyone staying behind to assist us.’ (P7, female, 34 years old)
Healthcare providers felt the pressure:
‘We have shortage of staff … Sometimes the clinic is full and the patients need to be attended on time.’ (H4, female, professional nurse)
While many appreciated the support from clinic staff, several participants shared experiences of being spoken to in ways that felt judgemental or discouraging – especially after missing appointments:
‘They will mock you … those words they tell you – “you will die,” “you are killing yourself,” “you will leave your family …”’ (P5, male, 46 years old)
‘People are hurt by their words … If you come to the clinic and someone talks to you like that, do you think that person will come back? No, he won’t.’ (P7, female, 34 years old)
‘When I go to the clinic they will mock me, telling me that I will die because I have defaulted my treatment. I then told myself that it’s better for me to stay at home.’ (P10, female, 34 years old)
These negative encounters made some fear returning to care after defaulting, worsening the risk of long-term disengagement.
Clinic tracing efforts (phone calls and home visits) were sometimes inconsistent, often because of workload or incorrect patient contact details:
‘We do telephone reminders though I cannot lie and say it is happening all the time.’ (H4, female, professional nurse)
‘The challenge is that they [
By scheduling appointments, healthcare providers thought they will reduce patient waiting time. The aim is to support consistent follow-up that include reminders and better tracking of missed appointment, allowing effective telephone tracing:
‘Maybe the strategy will be to find ways of following them through reminder calls.’ (H4, female, professional nurse)
‘From my opinion, the booking system will be good if we do it correctly.’ (H2, female, pharmacy assistant)
This study highlights how individual motivation, social support, health education and health system factors intersect to shape early retention in HIV care, drawing on the lived experiences of people with HIV and healthcare providers at a South African primary healthcare facility. While participants generally recognised the importance of lifelong ART, their narratives revealed that retention was shaped not only by clinical understanding but also by household dynamics, socioeconomic pressures and everyday encounters within the health system. Support from family, home-based care and peer interactions emerged as key enablers of continuity, while logistical challenges, stigma and health system inefficiencies posed ongoing barriers reinforcing the need for integrated, person-centred interventions tailored to the realities of patients in resource-limited settings.
Family support, peer interactions and home-based care emerged as critical structural enablers of retention in care among patients. Family members and sexual partners provided emotional support and practical guidance, helping individuals navigate barriers to consistent engagement with HIV services. Partner support was crucial for ART adherence in rural Malawi, while in rural Mpumalanga, partners also promoted safer sexual practices to support retention in care.
Counselling, encouragement and continuous engagement fostered patient empowerment and personal responsibility for ART. Consistent, non-judgemental counselling improved understanding of HIV and adherence, as supported by a Gauteng study where 97.6% of participants reported improved engagement following pre- and post-ART counselling.
Most patients highlighted that personal motivation, alongside clinical support, was key to sustained engagement, driven by a desire to stay healthy, care for their families, accept their status and learn from others’ experiences. Similar studies identified fear of disease progression, understanding treatment benefits and witnessing others’ outcomes as key motivators.
Relocation without transfer letters, work demands, poverty and fear of income loss were key barriers to retention in care. Similar challenges were reported in Limpopo, where long travel distances and demanding jobs hindered treatment access,
Some participants reported that fear of discrimination, challenges with disclosure and a lack of family support hindered their health-seeking behaviour, findings echoed in a study from Zambia.
Long waiting times and staff shortages at Kanyamazane CHC made clinic visits difficult, particularly those balancing work and family demands. Negative communication and inconsistent patient follow-up further contributed to poor retention. In Mozambique, time spent at health facilities was a key factor in patient satisfaction, while in Asia, effective communication with healthcare providers improved adherence.
Delayed and inconsistent telephone tracing at Kanyamazane CHC was largely because of staff shortages, with patients often contacted only after defaulting, and many unreachable because of incorrect contact details. This aligns with findings from Zambia, where telephone tracing was ineffective in re-engaging LTFU patients.
This study was limited to a single healthcare facility, which may affect the transferability of findings to other settings. All healthcare providers were female, a limitation in exploring male healthcare providers’ perspectives. The average mean age for patients was 40 years, a further limitation in exploring adolescents and elderly perspectives on retention to care. The perceived retention interventions and reported experiences reflect the views of clinic attendees and healthcare providers specific to the study site and may not be representative of broader populations.
Retention to care in the first year of ART at Kanyamazane CHC is shaped by deeply interconnected social, structural and individual factors. Strengthening peer support structures, addressing stigma both within clinics and in the community, expanding home-based care and improving health system functionality including patient flow and provider communication could significantly enhance retention. These findings reinforce the need for integrated, context-sensitive strategies that bridge clinical services and community-based support.
The authors would like to thank all the healthcare providers and patients who participated in this research, the Department of Health in Mpumalanga and the Ehlanzeni district for allowing us to conduct this research in their facility.
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
S.S. participated in the conception, design, data collection, data transcription, data analysis and drafting the initial manuscript. S.N. supervised and critically reviewed the manuscript.
Data sharing is not applicable to this article as no new data were created or analysed in this study.
The views and opinions expressed in this article are those of the authors and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or publisher. The authors are responsible for this article’s results, findings and content.
Perceptions and Experiences of Healthcare Providers and People Living with HIV on Retention to Care During the First 12 months of Treatment at Kanyamazane Community Health Centre.
Participant ID: 24/H00
Date of data collection: _____________
Respondent cadre _____________
| • Do you have > 6 months of working experience in this clinic? | Yes □ No □ |
| • Are you directly or indirectly involved in any HIV-related services or activities in this facility? | Yes □ No □ |
NB: If any of the above responses is NO, participant is not eligible for participation.
What is your gender?
Female Male Other
How old are you?………….
How long have you been working in this clinic?
Years………… Months……….
What is your highest completed level of education
Matric/post-matric certificate Diploma/Degree Masters/PhD
What interventions does this clinic use to support patients to keep on their treatment in the first year after starting ART?
When do you offer these interventions to patients after they have started on treatment?
Period on ART
0–3 months
4–6 months
7–9 months
10–12 months
Intervention (s) offered
Do you experience challenges or opportunities when offering such interventions to patients? Yes/No?
What challenges or opportunities do you experience when trying to offer one or more interventions?
Intervention
Challenges
Opportunities
What are your personal experiences regarding patients’ retention in care in the first year after starting ART at this clinic?
What do you think could be done to improve retention of patients in the first year of starting treatment at this clinic?
Why do you think your suggestions will work?
Perceptions and Experiences of people living with HIV and healthcare providers on retention to care strategies and interventions at Kanyamazane CHC in the first 12 months of ART initiation.
Participant ID: 24/P00
Name of facility/district/province: _____________
Date of data collection: _____________
| • Are you 18 years or older? | Yes □ No □ |
| • Are you currently on ART at this clinic? | Yes □ No □ |
| • Did you start your ART at this clinic? | Yes □ No □ |
| • Do you have less than 1 year on ART at this clinic? | Yes □ No □ |
NB: If any of the above responses is NO, participant is not eligible for participation.
What is your gender?
Female Male Other
What is your employment status?
Employed Not Employed Self-employed
What is your highest level of education that you completed?
No schooling Primary school Secondary school Tertiary qualification, for example, College
What are the health services available to support you to remain in your treatment in this clinic?
Have you ever been offered one or more of these services? Yes/No. If the answer is yes, did you accept the offer? Yes/No If you accepted the offer, please tell me more……..
Do you think is helpful to have such services offered to you? Yes/No. Kindly explain your answer.
What challenges are you experiencing from these health services? What opportunities are you experiencing from these health services?
Have you previously stopped collecting your treatment in this clinic? Yes/No. If yes, for how long?
Why are you so good at staying on your HIV treatment? (not applicable to LTFU)
Why do you think other people give up on their treatment in the first year?
What do you think the clinic can do to help you stay on your treatment in the future?
Tell me more why you stopped collecting your treatment at this clinic?
What motivated or encouraged you to return to your treatment?
How was your experience with the clinic staff when you return back?
What do you think the clinic could have done or can do differently to help you stay on your treatment?