‘I want to live a healthy life’: A qualitative study about the role of counselling in people’s motivations to start and continue using HIV treatment in Johannesburg, South Africa.

Abstract

HIV-related counseling is crucial for treatment initiation and adherence. Understanding the experiences of people living with HIV (PLWHIV) in initiating and staying on treatment is essential to address the challenges they may face. This thesis explores the experiences and motives of PLWHIV regarding antiretroviral therapy (ART) initiation and adherence, with a specific focus on the role of healthcare providers in Johannesburg, South Africa. The study utilizes an existing qualitative dataset consisting of 50 interviews to understand the barriers and facilitators to adherence, using the Multidimensional Adherence Model. For this study, 22 interviews were coded using a priori codes based on the SIMB-CIM model and the Multidimensional Adherence Model, which include information, motivation, behavioral skills, and health system organization. In addition to the a priori codes, an inductive thematic analysis was conducted to investigate emerging codes. The study reveals that healthcare providers play a significant role in informing and motivating PLWHIV to initiate and adhere to ART through HIV-related counseling. However, their involvement in supporting behavioral skills for adherence appears to be less pronounced, although counseling after ART initiation can also be beneficial. The findings emphasize the need for improved quality and content of structural HIV-related counseling in South Africa.