Factors Influencing Enrollment in Treatment for HIV/AIDS in Zambia

Project Description

Despite Zambia’s rapid scale-up of antiretroviral therapy, the number of Zambians on antiretroviral therapy (ART) is thought to be only about half to two-thirds of the number of those who are medically eligible. It is believed that the barriers to enrolling patients in ART differ by location: in urban areas, patients may seek ART but find there are too few facilities to accommodate them, while in rural areas, many patients medically eligible for treatment may never seek care despite ART availability. How Zambia’s national treatment program responds to these issues will be an important determinant of its long-term sustainability. In order to ensure effectiveness over time, ART programs must develop culturally appropriate and efficient practices for ART allocation as well as reach rural and other marginalized populations.

To identify barriers to and facilitators of antiretroviral treatment-seeking among those medically eligible for HIV treatment, the CGHD conducted a cross-sectional survey among 400 patients on ART (those who were able to access care) and 400 patients accessing home-based care (HBC), but who had not initiated ART (either they were not able to, or chose not to, access care) in two rural and two urban sites in Zambia to identify barriers to and facilitators of ART uptake.

At the conclusion of the study, the CGHD found that patients in home-based care for HIV/AIDS who never initiated ART perceived greater financial and logistical barriers to seeking HIV care and had more negative perceptions about the benefits of the treatment. Future efforts to expand access to antiretroviral care should consider ways to reduce these barriers in order to encourage more of those medically eligible for antiretrovirals to initiate care.

Project Details

Principal Investigator Matthew Fox
Boston University Co-Investigators Godfrey BiembaArthur MazimbaSydney Rosen, Philip Seidenberg
Country(ies) Zambia
Dates of Research 2007 – 2009