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      The price of adherence: qualitative findings from HIV positive individuals purchasing fixed-dose combination generic HIV antiretroviral therapy in Kampala, Uganda.

      AIDS and Behavior
      Adult, Anti-Retroviral Agents, therapeutic use, Attitude to Health, Catchment Area (Health), Cost of Illness, Drug Therapy, Combination, Drugs, Generic, Female, HIV Infections, drug therapy, epidemiology, psychology, Health Behavior, Humans, Longitudinal Studies, Male, Patient Compliance, Uganda

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          Abstract

          Contrary to early expectations, recent studies have shown near-perfect adherence to HIV antiretrovirals in sub-Saharan Africa We conducted qualitative interviews with patients purchasing low-cost, generic antiretroviral therapy to better understand the social dynamics underlying these findings. We found that concerns for family well-being motivate adherence, yet, the financial sacrifices necessary to secure therapy may paradoxically undermine family welfare. We suggest that missed doses may be more due to a failure to access medication rather than a failure to adhere to medications, and that structural rather than behavioral interventions may be most useful to insure optimal treatment response.

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