{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:48:42Z","timestamp":1785433722254,"version":"3.56.0"},"reference-count":30,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Human 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\u2019 adherence to ARV therapy is important to ensure continued viral suppression.\n\nAim:\u00a0The study aimed to report on the experiences of primary health care (PHC) nurses in monitoring patients\u2019 adherence to ARV therapy in PHC facilities in Mpumalanga, South Africa.\n\nSetting:\u00a0Six PHC clinics in a district in Mpumalanga were purposively selected.\n\nMethods:\u00a0Employing 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.\n\nResults:\u00a0The findings revealed four themes: PHC nurses\u2019 experience in monitoring patients\u2019 adherence to ARV therapy in PHC facilities, experience of external challenges influencing patient\u2019s adherence to ARV therapy, experiences in internal challenges that influence patients\u2019 ARV therapy adherence, and the consequences of non-monitoring and poor adherence.\n\nConclusion:\u00a0Non-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.\n\nContribution:\u00a0The findings 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.<\/jats:p>","DOI":"10.4102\/phcfm.v17i1.4841","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T20:06:44Z","timestamp":1746043604000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Experiences of nurses in patient adherence to antiretoroviral therapy in Mpumalanga, South Africa"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6533-4801","authenticated-orcid":false,"given":"Kabelo","family":"Moroko","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04z6c2n17","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Johannesburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3345-4717","authenticated-orcid":false,"given":"Zelda","family":"Janse van Rensburg","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04z6c2n17","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Johannesburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0864-5834","authenticated-orcid":false,"given":"Wanda","family":"Jacobs","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04z6c2n17","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Johannesburg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"ref0","unstructured":"World Health Organization. HIV and AIDS [homepage on the Internet]. 2023 [cited 2024 May 21]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids"},{"key":"ref1","unstructured":"UNIAIDS. Global HIV statistics [homepage on the Internet]. 2021 [cited 2024 May 20]. Available from: https:\/\/embargo.unaids.org\/static\/files\/uploaded_files\/UNAIDS_2021_FactSheet_en_em.pdf"},{"key":"ref2","unstructured":"Statistics South Africa. 2020 Mid-year estimates [homepage on the Internet]. 2020 [cited 2024 May 20]. Available from: https:\/\/www.statssa.gov.za\/?p=13453"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Schiever JF, Visser J, Van der Merwe M, Nel DG. Evaluation of nutrition care to adult patients on HAART attending primary healthcare facilities in Mpumalanga. S Afr J Clin Nutr. 2019;32(1):13\u201320. https:\/\/doi.org\/10.1080\/16070658.2017.1412183","DOI":"10.1080\/16070658.2017.1412183"},{"key":"ref4","unstructured":"United States Department of Health and Human Services. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV [homepage on the Internet]. 2021 [cited 2024 May 20]. Available from: https:\/\/clinicalinfo.hiv.gov\/en\/guidelines\/adult-and-adolescent-arv\/whats-new-guidelines"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Scriven YA, Mulinge MM, Saleri N, et al. Prevalence and factors associated with HIV-1 drug resistance mutations in treatment-experienced patients in Nairobi, Kenya: A cross-sectional study. Medicine (United States). 2021;100(40):E27460. https:\/\/doi.org\/10.1097\/MD.0000000000027460","DOI":"10.1097\/MD.0000000000027460"},{"key":"ref6","unstructured":"South Africa Department of Health. National consolidated guidelines for the management of HIV in adults, adolescents, children and infants and prevention of mother-to-child transmission [homepage on the Internet]. 2020 [cited 2024 May 20]. Available from: https:\/\/knowledgehub.health.gov.za\/system\/files\/elibdownloads\/202304\/National%2520Consolidated%2520Guidelines%252030062020%2520signed%2520PRINT%2520v7.pdf"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Bukenya D, Mayanja BN, Nakamanya S, Muhumuza R, Seeley J. What causes non-adherence among some individuals on long term antiretroviral therapy? Experiences of individuals with poor viral suppression in Uganda. AIDS Res Ther. 2019;16(1):2. https:\/\/doi.org\/10.1186\/s12981-018-0214-y","DOI":"10.1186\/s12981-018-0214-y"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Murphy JP, Kgowedi S, Coetzee L, et al. Assessment of facility-based tuberculosis data quality in an integrated HIV\/TB database in three South African districts. PLoS Glob Public Health. 2022;2(9):e0000312. https:\/\/doi.org\/10.1371\/journal.pgph.0000312","DOI":"10.1371\/journal.pgph.0000312"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bvochora T, Satyanarayana S, Takarinda KC, et al. Enhanced adherence counselling and viral load suppression in HIV seropositive patients with an initial high viral load in Harare, Zimbabwe: Operational issues. PLoS One. 2019;14(2):e0211326. https:\/\/doi.org\/10.1371\/journal.pone.0211326","DOI":"10.1371\/journal.pone.0211326"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Chamberlin S, Mphande M, Phiri K, Kalande P, Dovel K. How HIV clients find their way back to the ART clinic: A qualitative study of disengagement and re-engagement with HIV care in Malawi. AIDS Behav. 2022;26(3):674\u2013685. https:\/\/doi.org\/10.1007\/s10461-021-03427-1","DOI":"10.1007\/s10461-021-03427-1"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Bisnauth MA, Davies N, Monareng S, et al. Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient\u2019s perspective in Johannesburg, South Africa. PLoS One. 2021;16(9):e0256540. https:\/\/doi.org\/10.1371\/journal.pone.0256540","DOI":"10.1371\/journal.pone.0256540"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Anderegg N, Hector J, Jefferys LF, et al. Loss to follow-up correction increased mortality estimates in HIV\u2013positive people on antiretroviral therapy in Mozambique. J Clin Epidemiol. 2020;128:83\u201392. https:\/\/doi.org\/10.1016\/j.jclinepi.2020.08.012","DOI":"10.1016\/j.jclinepi.2020.08.012"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Van Heerden A, Ntinga X, Lippman SA, Leslie HH, Steward WT. Understanding the factors that impact effective uptake and maintenance of HIV care programs in South African primary health care clinics. Arch Public Health. 2022;80(1):221. https:\/\/doi.org\/10.1186\/s13690-022-00975-3","DOI":"10.1186\/s13690-022-00975-3"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Ramukumba MM. Exploration of community health workers\u2019 views about in their role and support in primary health care in Northern Cape, South Africa. J Community Health. 2020;45(1):55\u201362. https:\/\/doi.org\/10.1007\/s10900-019-00711-z","DOI":"10.1007\/s10900-019-00711-z"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Tshililo AR, Mangena-Netshikweta L, Nemathaga LH, Maluleke M. Challenges of primary healthcare nurses regarding the integration of HIV and AIDS services into primary healthcare in Vhembe district of Limpopo province, South Africa. Curationis. 2019;42(1):1\u20136. https:\/\/doi.org\/10.4102\/curationis.v42i1.1849","DOI":"10.4102\/curationis.v42i1.1849"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Shamu S, Slabbert J, Guloba G, et al. Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of nongovernmental organisations in a South African district. PLoS One. 2019;14(1):e0210826. https:\/\/doi.org\/10.1371\/journal.pone.0210826","DOI":"10.1371\/journal.pone.0210826"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Potsane P. Factors associated with patients defaulting on HIV treatment at Helen Joseph Hospital, Gauteng province, South Africa. Afr J AIDS Res. 2023;22(2): 85\u201391. https:\/\/doi.org\/10.2989\/16085906.2023.2197880","DOI":"10.2989\/16085906.2023.2197880"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Mabunda K, Ngamasana EL, Babalola JO, Zunza M, Nyasulu P. Determinants of poor adherence to antiretroviral treatment using a combined effect of age and education among human immunodeficiency virus infected young adults attending care at Letaba Hospital HIV clinic, Limpopo Province, South Africa. Pan Afr Med J. 2019;32:37. https:\/\/doi.org\/10.11604\/pamj.2019.32.37.17722","DOI":"10.11604\/pamj.2019.32.37.17722"},{"key":"ref19","unstructured":"Allinder SM, Fleischman J. The world\u2019s largest HIV epidemic in crisis: HIV in South Africa [homepage on the Internet]. 2019 [cited 2024 May 22]. Available from: https:\/\/www.csis.org\/analysis\/worlds-largest-hiv-epidemic-crisis-hiv-south-africa"},{"key":"ref20","unstructured":"Gert Sibande District Municipality [homepage on the Internet]. 2024 [cited 2025 Feb 12]. Available from: https:\/\/www.gsibande.gov.za\/"},{"key":"ref21","unstructured":"Human Science Research Council. Mpumalanga Province grapples with highest HIV prevalence rate in SA [homepage on the Internet]. 2024 [cited 2025 Feb 12]. Available from: https:\/\/hsrc.ac.za\/press-releases\/phsb\/mpumalanga-province-grapples-with-highest-hiv-prevalence-rate-in-sa\/"},{"key":"ref22","unstructured":"Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. 9th ed. Philadelphia, PA: Wolters Kluwer Publishers; 2021."},{"key":"ref23","unstructured":"Giorgi A, Giorgi B, Morley J. The descriptive phenomenological psychological method [homepage on the Internet]. 2017 [cited 2024 May 20]. Available from: https:\/\/www.researchgate.net\/publication\/318451180"},{"key":"ref24","unstructured":"Gray JR, Grove SK. Burns and Grove\u2019s the practice of nursing research: Appraisal, synthesis, and generation of evidence. 8th ed. St Louis, MO: Elsevier; 2021."},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Robbins RN, Kluisza L, Nguyen N, et al. Measuring ART adherence among young adults with perinatally acquired HIV: Comparison between self-report, telephone-based pill count, and objective pharmacologic measures. AIDS Behav. 2023;27(12):3927\u20133931. https:\/\/doi.org\/10.1007\/s10461-023-04107-y","DOI":"10.1007\/s10461-023-04107-y"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Bachanas P, Alwano MG, Lebelonyane R, et al. Finding, treating and retaining persons with HIV in a high HIV prevalence and high treatment coverage country: Results from the Botswana Combination Prevention Project. PLoS One. 2021;16(4):e0250211. https:\/\/doi.org\/10.1371\/journal.pone.0250211","DOI":"10.1371\/journal.pone.0250211"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Ngcobo S, Rossouw T. Acceptability of home-based HIV care offered by community health workers in Tshwane District, South Africa: A survey. AIDS Patient Care STDS. 2022;36(2):55\u201363. https:\/\/doi.org\/10.1089\/apc.2021.0216","DOI":"10.1089\/apc.2021.0216"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Bogart LM, Shazi Z, MacCarthy S, et al. Implementation of South Africa\u2019s central chronic medicine dispensing and distribution program for HIV treatment: A qualitative evaluation. AIDS Behav. 2022;26(8):2600\u20132612. https:\/\/doi.org\/10.1007\/s10461-022-03602-y","DOI":"10.1007\/s10461-022-03602-y"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Karugaba G, Simpson J, Mathuba B, et al. The barriers and facilitators of HIV-exposed infant testing as perceived by HIV-positive mothers in Botswana: A qualitative study. PLoS One. 2022;17(8):e0273777. https:\/\/doi.org\/10.1371\/journal.pone.0273777","DOI":"10.1371\/journal.pone.0273777"}],"container-title":["African Journal of Primary Health Care &amp; Family Medicine"],"original-title":[],"link":[{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/viewFile\/4841\/8162","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/viewFile\/4841\/8163","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/viewFile\/4841\/8164","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/viewFile\/4841\/8165","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/4841\/8165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T08:32:16Z","timestamp":1762331536000},"score":1,"resource":{"primary":{"URL":"https:\/\/phcfm.org\/index.php\/phcfm\/article\/view\/4841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/phcfm.v17i1.4841","relation":{},"ISSN":["2071-2928","2071-2936"],"issn-type":[{"value":"2071-2928","type":"print"},{"value":"2071-2936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,30]]},"article-number":"a4841"}}