Perceptions and experiences of men on antiretroviral treatment lost to follow-up in Govan Mbeki, Mpumalanga

Abstract

BACKGROUND : Retention on antiretroviral treatment (ART) is essential for achieving viral suppression and preventing HIV transmission. However, men living with HIV in sub-Saharan Africa are disproportionately lost to follow-up (LTFU), posing significant public health challenges. OBJECTIVES : To explore the perceptions, experiences and barriers to ART adherence among men LTFU on ART treatment at three primary healthcare (PHC) facilities in the Govan Mbeki sub-district, Mpumalanga. METHOD : Qualitative, descriptive, and explorative contextual research methodologies were used to collect data among 21 LTFU men from three PHC facilities in the Govan Mbeki sub-district. Participants were selected using heterogenous purposive sampling, and the sample size was determined by data saturation. Semi-structured, in-depth interviews were conducted from May 2024 to July 2024. The data were thematically analysed using NVivo 14. RESULTS : The study identified key factors affecting ART adherence among men, including stigma, work-related barriers, long clinic waiting times, and medication side effects. Economic pressures, poor service delivery, and negative attitudes from healthcare staff further contributed to ART default. Suggested improvements include extended service hours, male-friendly environments, and better communication with healthcare providers. CONCLUSION : This study underscores the complex interplay of barriers driving ART disengagement among men and highlights the need for multi-pronged strategies to improve retention. Addressing these barriers is critical for achieving equitable HIV care outcomes and advancing progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets.