Community health workers' perceptions of factors contributing to loss to follow-up of patients on antiretroviral therapy and residing in an informal settlement in the Tshwane district

Abstract

Introduction Antiretroviral therapy is a lifelong combination of at least three medications administered and taken by people living with the Human Immunodeficiency Virus to decrease the viral load and halt disease development. Antiretroviral therapy reduces the morbidity and mortality rates associated with Human Immunodeficiency Virus (HIV). Adherence to Antiretroviral therapy improves patients' quality of life, reduces drug resistance, lowers the occurrence of opportunistic infections, halts disease progression, and lowers hospital re-admissions and death. Community health workers play a key role in antiretroviral therapy care, bridging the gap between healthcare facilities and individuals living with human immunodeficiency virus. They provide support, education, and assistance to ensure medication adherence, disease management, and continuity of care. Through their dedication and empathy, they contribute significantly to improving health outcomes and reducing the impact of Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome in communities.

Purpose of the study To explore and describe community health workers' perceptions of factors contributing to the loss of follow-up of patients on antiretroviral therapy living in an informal settlement in the Tshwane District.

Research design and methodology The study was conducted in an informal settlement in Tshwane District. A qualitative, exploratory, descriptive, and contextual research design was adopted. Purposive sampling was utilised to sample study participants, and in-depth, face-to-face, individual interviews were conducted with 15 Community Health Workers. Data collection proceeded until saturation was attained. Tesch’s method of qualitative data analysis was utilised to analyse the data. The measures of trustworthiness were used to ensure quality throughout the study.

Findings Five themes were articulated from the findings. The findings encapsulated a number of systemic and individual-related factors, which contributed to loss to follow up of patients on antiretroviral therapy. Theme one was ‘Individual-related factors’, theme two was ‘Negative consequences of being on ART’, theme three was ‘System-related factors’, the fourth theme was ‘Attitudes, behaviours and practices at the health facilities’, and lastly the fifth theme was ‘Recommendations to improve follow-up’. Numerous pieces of literature from all across the world, as well as from South Africa, backed up the study's conclusions. Based on the findings, we identified and advised actions for the community, health facilities, the Department of Health, and future studies.