Qualitative study of factors associated with antiretroviral therapy drop-out among HIV-infected patients in Wenshan prefecture, Yunnan Province

Objective To assess factors associated with antiretroviral therapy (ART) drop-out among human immunodeficiency virus (HIV)-infected patients in Wenshan prefecture, Yunnan Province. Methods Patients who discontinued ART, family members of patients who discontinued ART, and ART providers were recruited by purposive sampling from 3 ART clinics in Wenshan and Maguan counties according to the principle of maximum difference of subjects and sample size was determined by saturation, face to face in-depth interview was used to explore factors associated with ART drop-out on personal level, family level and clinic level. Results After an in-depth interview of 43 patients who discontinued ART, aged (47.8±15.6) years, and 7 family members of patients who discontinued ART and 11 ART providers, we found that side effect, lack of cognition about ART, fear of exposure, stigma, psychological burden about ART, opting for alternative treatment were influential factors for personal level associated with ART drop-out; support from family, accessibility of ART and service in ART clinic were exterior factors influencing ART drop-out. Conclusions Factors for ART drop-out among HIV-infected patients in Wenshan prefecture are multifaceted, thus, comprehensive intervention strategies on personal, family and clinic levels should be taken to reduce ART drop-out.