Abstract:
OBJECTIVE: People living with HIV (PLHIV) are often
recruited from primary healthcare clinics (PHC) into clinical
trials. On trial completion, they are transferred back to the
facility for continued care and support in managing their
condition, potentially leading to better health outcomes.
Because transferring PLHIV back to PHCs post-clinical
trials may result in decreased access to specialised
care or resources that were available during the trial,
this study explored insights into challenges faced during
reintegration from clinical trial settings into PHCs and
antiretroviral therapy (ART) adherence post-clinical trials.
DESIGN: This cross-sectional study was conducted using a
qualitative research approach. Participants were recruited
using purposive sampling.
SETTING: The study was conducted at the Ezintsha
Research Centre in Johannesburg, South Africa, between
November 2022 and February 2023.
PARTICIPANTS: The study population consisted of PLHIV who
had participated in two clinical trials (DORA and ADVANCE)
at the Ezintsha Research Centre in Johannesburg, South
Africa.
METHODS: Using a semistructured guide, 12 in-depth
interviews were conducted with PLHIV until data saturation
was reached. Data were then transcribed verbatim and
analysed thematically with MAXQDA software.
RESULTS: The majority (n=8, 67%) of participants were
female, and the average age of all participants was 40
(SD 7.2) years. Two main themes emerged: reintegration
from clinical trials to public healthcare and barriers to
ART adherence. These themes were further separated
into seven subthemes, namely, negative attitude of
healthcare workers, poor healthcare service delivery, poor
communication to patients, waiting time at healthcare
facilities, lack of privacy and confidentiality, mistakes in
ART dispensing and bad reception at facilities post-clinical
trials.
CONCLUSION: Clinical trial sites should cultivate better
stakeholder engagement with PHCs to facilitate a
smoother transition of research participants, especially
PLHIV, back into public healthcare for continued care.
