Table 2 Categories, themes, and supporting themes for participants’ experiences with antiretroviral therapy in Northwest Ethiopia, 2022
Categories | Themes | Supporting quotes |
|---|---|---|
Perceived/anticipated stigma | Stigma | “I take my drug in a hiding place when my child sleeps since she didn’t know about my status. I always come from a remote area which takes 1 h by bus since there is still a stigma in our community. My social life and work could be affected if I get service in my locality”. (33 years old female) “No one knows about my HIV status except my wife hence I didn’t experience discrimination from others”. (56 years old male) “My husband’s family members considered me as doing some evil activity on him. They advised him to stop the HIV drug and rather go to a traditional healer”. (57 years old female) “I have an experience of discrimination by a woman with a rental dorm. She refused to accept me to rent in her house as a result of knowing my HIV status”. (27 years old female) “I have found a discriminatory action by the gatekeepers. They [gatekeepers] openly asked me the reason for the entry to the hospital in front of many people requesting to enter the hospital during COVID-19 movement restriction”. (40 years old male) |
Enacted stigma from family | ||
Enacted stigma from the community | ||
Enacted stigma from the healthcare setting | ||
Waiting time | Time | ‘‘The main challenge was the long queues here. You may wait for a long time or even postpone to the next day by taking the emergency drugs only’’. (22 years old male) ‘‘I didn’t see the clinic operating on the weekends and before 2:30 in the morning or after 11:30 in the afternoon from Monday to Friday’’. (40 years old female) ‘‘It takes me 2 h of travel by bus’’. (40 years old female) “I was visiting the facility every month for 7 years”. (22 years old male) “The laboratory test clashes with my education schedule since the facility always tell me to come in the morning where there may be a class in the school”. (22 years old female) ‘‘I am still frustrated with disclosing my status to others. I tried to request one of the providers here and she send me my drugs via postal service since I was not able to come on the appointment date due to a clash with my work’’. (33 years old female) |
Facility operation time | ||
Travel time | ||
Frequency of health facility visit | ||
Time convenience with school and work | ||
Costs of transportation | Costs per clinic visit | ‘‘I come from a remote area which takes 1 h by bus with 60 birr cost. Since there is still a stigma in our community, I am forced to come here for getting ART service. I may take paying fewer costs for a taxi if I attended in my locality’’. (33 years old female) ‘‘I pay for the transport and food costs when I come here. But, I do not pay for drugs at this hospital since I have no opportunistic infections’’. (40 years old male) ‘‘I have discussed with my providers to give me drugs with additional stock at least for 10 days in addition to the usual prescription to avoid work inconvenience’’. (33 years old female) |
Costs of drugs for opportunistic infections | ||
Additional costs including food | ||
Cost of missing work when seeking care | ||
Attitudes and behaviors of healthcare workers | Provider–patient interaction | “The providers are kind enough to treat us. Some providers have HIV and help us properly. They [providers with HIV] counsel us very helpful in a good manner. It is like knowing about the hungry status of someone by remembering their own hungry experience. I always want to contact them”. (33 years old female) ‘‘I found most providers are good at providing services including counseling. But some providers are not showing bright faces, do not give adequate counseling and simply order to take drugs for 3 or 6 months, and even do not close the door which affects our privacy’’. (38 years old male) |
Counseling | ||
Drug availability | Drug and provider availability | ‘‘I am satisfied with the drug supply in this hospital’’. (40 years old female) ‘‘The current service is not bad. It could be better if there are an adequate number of providers here’’. (22 years old male) |
Providers’ availability |