Experiences of nurses in patient adherence to antiretoroviral therapy in Mpumalanga, South Africa

Background: Human immunodeficiency virus (HIV) is a global health pandemic. Mpumalanga is a province with a high burden of HIV or acquired immunodeficiency syndrome (AIDS). Antiretroviral (ARV) therapy should be initiated for all HIV-positive patients. Monitoring of patients' adherence to ARV therapy is important to ensure continued viral suppression. Aim: The study aimed to report on the experiences of primary health care (PHC) nurses in monitoring patients' adherence to ARV therapy in PHC facilities in Mpumalanga, South Africa. Setting: Six PHC clinics in a district in Mpumalanga were purposively selected. Methods: Employing a qualitative, exploratory, descriptive research design, 12 PHC nurses were interviewed in 2023. The data were coded, categorised and clustered into themes and categories. Ethical considerations and measures to ensure trustworthiness were adhered to. Results: The findings revealed four themes: PHC nurses' experience in monitoring patients' adherence to ARV therapy in PHC facilities, experience of external challenges influencing patient's adherence to ARV therapy, experiences in internal challenges that influence patients' ARV therapy adherence, and the consequences of non-monitoring and poor adherence. Conclusion: Non-adhering patients were seen to be the greatest challenge. More awareness regarding the central chronic medicine dispensing and distribution (CCMDD) programme and the development of guidelines on the support of PHC nurses and patients are recommended. Contribution: The indings of the study may guide recommendations to assist PHC nurses, PHC management and policy makers at large to address challenges in the monitoring and adherence of patients on ARV therapy.