"I found that I was well and strong": Women's motivations for remaining on ART under Option B+ in Malawi.

Phiri, Nozgechi; Haas, Andreas D; Msukwa, Malango T; Tenthani, Lyson; Keiser, Olivia; Tal, Kali (2018). "I found that I was well and strong": Women's motivations for remaining on ART under Option B+ in Malawi. PLoS ONE, 13(6), e0197854. Public Library of Science 10.1371/journal.pone.0197854

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Most Malawian women who start ART under Option B+ are still in care three years later, a higher than average adherence rate for life-threatening chronic disease treatments, worldwide (50%). We asked 75 Malawian on ART their motivations for remaining in treatment, and what barriers they overcame. Focus groups and interviews included 75 women on ART for 6+ months, at 12 health facilities. Four main motivations for continuing ART emerged: 1) evidence that ART improved their own and their children's health; 2) strong desire to be healthy and keep their children healthy; 3) treatment was socially supported; 4) HIV/ART counselling effectively showed benefits of ART and told women what to expect. Women surmounted the following barriers: 1) stigma; 2) health care system; 3) economic; 4) side effects. Women stayed on ART because they believed it works. Future interventions should focus on emphasizing ART's effectiveness, along with other services they provide.

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