Barriers to Adherence of Antiretroviral Treatment in a Prison of Tehran: A Qualitative Study

Abstract

Focus group discussion (FGD) was conducted on Ghezel-hesar prison of Karaj, Alborz province, to investigate the barriers to and facilitators of adherence to antiretroviral therapy (ART) in January, 2015.<strong> </strong> Participants reported illegal drug use, deficits in educating patients regarding HIV treatment, side effects of anti-retroviral drugs, treatment interruption, drug interactions, fear of hangover, poor diet, low socioeconomic background, hopelessness, depression, not believing in the treatment, rejection and lack of social support, stigma, obligatory break in the prison yard, lack of tendency toward visiting psychiatrists, lack of family support, forgetfulness, and not receiving complementary drugs as the barriers to adherence to ART. In addition, the facilitators of the treatment included physician-patient good communication, physician's compassion, providing patients with counseling services, educating patients regarding HIV treatment necessity, peer education, informing patients of CD4 level, educating correctional staffs in treating patients with courtesy, providing methadone on time, and improving patients' diet. Providing HIV-infected inmates with welfare programs and educating them regarding the adherence to ART may play a prominent role in the HIV treatment among HIV-infected inmates. Training correctional staffs concerning the significance of HIV treatment and adherence to ART can also be effective in the treatment of HIV-infected prisoners.