Treatment adherence in TB/HIV co-infected patients in Mount Frere, Eastern Cape.

Background: Adequate levels of adherence to treatment for tuberculosis (TB) and HIV at the same time poses a problem for public health in South Africa.TB/HIV co-infected patients face many potential barriers to adherence to treatment for both conditions.There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment.The aim of this study was to explore the barriers and facilitators to treatment adherence among people co-infected with TB/HIV living in the Alfred Nzo District, Eastern Cape, in order to identify the barriers and facilitators to adherence.Methodology: Exploratory qualitative methods were used to explore the barriers to Treatment adherence in TB/HIV co-infected patients in Mount Frere, Eastern Cape.In-depth, semi-structured interviews were conducted in isiXhosa with 17 non-adherent participants to TB/HIV treatment and three key informants who are health workers from Gateway clinic.The interviews were audio-recorded, transcribed and translated into English.The data was analysed using inductive thematic analysis.Results: Health facility and individual factors emerged as barriers to treatment adherence.Difficulties of taking treatment due to side effects, problems with monetary resources resource, patient's education about treatment, associating TB with HIV and social support and stigma were all factors related to treatment barriers identified by both key informants and the participants.Health facility related to treatment barriers were availability of medication and workload and staff shortages resulting in long waiting times.Conclusion: Despite program integration of TB/HIV programs and free availability of medication, barriers to adherence still exist.Most of barriers have been articulated in previous research that focussed on treatment adherence in patients who are on both TB/HIV medication.The fact that the barriers remain suggests that these barriers are complex and