“Our Tradition Our Enemy”: A Qualitative Study of Barriers to Women’s HIV Care in Jimma, Southwest Ethiopia

Hailay Gesesew, Pamela Lyon, Paul Ward, Kifle Woldemichael, Lillian Mwanri

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    Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men; (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs; (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men; (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains. View Full-Text
    Keywords: barriers; delayed HIV diagnosis; discontinuation; Ethiopia; HIV care continuum; interventions; qualitative; tradition; women
    Original languageEnglish
    Article number833
    Number of pages11
    JournalInternational Journal of Environmental Research and Public Health
    Issue number3
    Publication statusPublished - 29 Jan 2020

    Bibliographical note

    This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited


    • Barriers
    • Delayed HIV diagnosis
    • Discontinuation
    • Ethiopia
    • HIV care continuum
    • Interventions
    • Qualitative
    • Tradition
    • Women


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