Original Research

Social and economic barriers to adherence among patients at Livingstone General Hospital in Zambia

Kaala Moomba, Brian van Wyk
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a1740 | DOI: https://doi.org/10.4102/phcfm.v11i1.1740 | © 2019 Kaala Moomba, Brian Van Wyk | This work is licensed under CC Attribution 4.0
Submitted: 09 January 2018 | Published: 16 April 2019

About the author(s)

Kaala Moomba, School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
Brian van Wyk, School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa


Background: Zambia is one of the countries hardest hit by the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic with a national HIV prevalence estimated at 14% among those aged 15–49 years in 2012. Antiretroviral therapy (ART) has been available in public health facilities in Zambia since 2003. By early 2016, 65% of the 1.2 million Zambians living with HIV were accessing ART. While access to ART has improved the lives of people living with HIV globally, the lack of adherence to ART is a major challenge to treatment success globally.

Aim: This article reports on social and economic barriers to ART adherence among HIV patients being attended to at Livingstone General Hospital in Zambia.

Setting: Livingstone General Hospital is located in the Southern province of Zambia, and had over 7000 patients enrolled for HIV care of whom 3880 patients were on ART.

Methods: An explorative, qualitative study was conducted with 42 patients on ART where data were collected through six focus group discussions (3 male and 3 female groups) and seven in-depth interviews. Data were audio-recorded and transcribed verbatim and subjected to thematic content analysis.

Results: Economic factors such as poverty and unemployment and the lack of food were reported as major barriers to adherence. Furthermore, social factors such as traditional medicine, religion, lack of family and partner support, and disclosure were also reported as critical barriers to adherence to ART.

Conclusion: Interventions to improve adherence among ART patients should aim to redress the socio-economic challenges at community and individual levels.


adherence; HIV; treatment; barriers; social; economic


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Crossref Citations

1. Barriers and facilitators for interventions to improve ART adherence in Sub-Saharan African countries: A systematic review and meta-analysis
Amos Buh, Raywat Deonandan, James Gomes, Alison Krentel, Olanrewaju Oladimeji, Sanni Yaya, Taurayi A Tafuma
PLOS ONE  vol: 18  issue: 11  first page: e0295046  year: 2023  
doi: 10.1371/journal.pone.0295046