Antiretroviral Therapy in Egypt: Are There Any Barriers to Medication Adherence?

Background: Egypt provides free antiretroviral therapy (ART) to some 5000 Egyptian
People Living with HIV/AIDS (PLWHA) across a number of distribution points. Objective:
This study aimed mainly at identifying potential facilitators and barriers to ART. Method:
Focus groups discussions (FGDs) were conducted with 33 PLWHA representing most of
Egyptian geographical areas. Discussions were designed to cover socio-demographic
characteristics of participants, routine investigations, monitoring & follow up measures,
problems associated with drug intake, PLWHA needs, stigma, and relevant future concerns.
Results: Participants confirmed availability of drugs without interruptions almost all months,
yet, for the majority (63.7%) of participants, investigations were done during the process of
tracing their clinical complaints that were behind first HIV testing, while treatment was
initiated without prior relevant investigations for (36.4%) of participants. The majority
(75.75%) of participants did not receive adequate counseling before starting their treatment.
Almost two thirds (63.6%) of participants initiated drugs at late stage of the disease. All
participants (100.0%) expressed their needs for a well-trained person at each center. The
treatment had troublesome side effects in the form of drowsiness and loss of concentration
among (72.72%) of participants. All (100%) of participants mentioned different stigmatizing
practices against them at treatment facilities. Conclusion: Lack of accurate information about
HIV and ART, inadequate Monitoring and follow up measures, drug side effects and
stigmatizing practices against Egyptian PLWHA represent the most common barriers to ARV
therapy.