The efficacy of antiretroviral therapy (ART) hinges on the adherence of people living with HIV (PLHIV) to the prescribed regimen. This qualitative study aimed to explore the factors contributing to poor ART adherence among PLHIV at Nolungile Community Health Clinic in Khayelitsha.

The research analysed a sample of 35 participants from a population of more than 50 000 individuals served by the clinic. Primary data collection involved semi-structured interviews using a paper-based interview guide, with thematic analysis employed for data interpretation.

The findings uncovered a multitude of factors influencing poor ART adherence, including the clinical environment, patient-related aspects, suboptimal patient-provider relationships, misinformation, ART side effects, disease characteristics, psychological variables, substance abuse and social support. The study also highlighted inadequate knowledge among PLHIV regarding ART adherence as a significant contributor to non-adherence.

Recommendations to address the identified factors included enhancing patient-provider relationships, implementing automated and integrated medical record systems and fostering improved communication between healthcare providers and PLHIV.