Financial obligations and economic barriers to antiretroviral therapy experienced by HIV-positive women who participated in a job-creation programme in northern Uganda - PubMed (original) (raw)

Financial obligations and economic barriers to antiretroviral therapy experienced by HIV-positive women who participated in a job-creation programme in northern Uganda

Kathryn Dovel et al. Cult Health Sex. 2016.

Abstract

Economic costs are commonly cited as barriers to women's use of antiretroviral therapy (ART) in sub-Saharan Africa; however, little is known about how changes in women's income influence economic barriers to care. We analysed in-depth interviews with 17 HIV-positive women who participated in a job-creation programme in northern Uganda and two key informant interviews with programme staff to examine lingering economic barriers to care experienced after programme enrollment. We found that participants continued to experience economic barriers even after receiving a steady income and improving their economic status. Two themes emerged: first, limited resources in health facilities (e.g. drug and staff shortages) led participants to view ART utilisation as a primarily economic endeavour where clients made informal payments for prompter service or sought treatment in private facilities where ART was readily available; second, increased economic status among participants increased expectations of economic reciprocity among participants' social networks. Financial obligations often manifested themselves in the form of caring for additional dependents, limiting the resources women could allocate toward their HIV treatment. When paired with limited resources in health facilities, increased financial obligations perpetuated the economic barriers experienced by participants. Job-creation programmes should consider how health institutions interact with participants' financial obligations to influence women's access to HIV services.

Keywords: HIV; barriers to ART utilisation; income-generating programmes; northern Uganda; women.

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References

    1. Arbache J, Kolev A, Filipik E. Gender Disparities in Africa’s Labor Market. Washington, D.C.: The International Bank for Reconstruction and Development/The World Bank; 2010.
    1. Arrivillaga M, Springer A, Lopera M, Correa D, Useche B, Ross M. HIV/AIDS treatment adherence in economically better off women in Colombia. AIDS Care. 2012;24(7):929–935. -PubMed
    1. Barnes C. Microfinance and Mitigation of the Impacts of HIV/AIDS: An Exploratory Study from Zimbabwe. Washington D.C.: Assessing the Impact of Microenterprise Services (AIMS) Project; 2002. [Accessed June 15, 2014]. http://www.mip.org/pdfs/aims/brief34.pdf.
    1. Bateganya M, Amanyeiwe U, Roxo U, Dong M. Impact of support groups for people living With HIV on clinical outcomes: a systematic review of the literature. Journal of Acquired Immune Deficiency Syndromes. 2015;68:S368–S374. -PMC -PubMed
    1. Boyatzis R. Transforming qualitative information: Thematic analysis and code development. Thousand Oaks, CA: SAGE; 1998.

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