Perceptions of dolutegravir-based regimen use among people living with HIV in Limpopo province: A qualitative study

Abstract

Background: HIV and AIDS continues to be a critical public health challenge, with sub-Saharan Africa shouldering the heaviest burden. Progress towards disease management has been implemented over the years, and antiretroviral therapy (ART) has been the most significant milestone. The World Health Organization recommended dolutegravir as the second line of treatment for the disease. A dolutegravir-based regimen has been appreciated for its great benefits. While its effectiveness is apparent, reports of side effects have raised concerns about adherence, posing a challenge to long-term treatment success.
Objectives: This study explored the perceptions of people living with HIV (PLHIV) in Limpopo province regarding the use of dolutegravir-based regimens.
Method: A qualitative, explorative-descriptive design was followed. Twenty individual semi-structured interviews were conducted. Purposive sampling and sample size were determined when data saturation was reached. Thematic analysis was used.
Results: Four major themes emerged: high acceptance of dolutegravir, limited knowledge of treatment details, the burden of managing long-term ART and barriers to adherence, including concerns about side effects.
Conclusion: While dolutegravir was generally well accepted, there were notable deficiencies in understanding treatment, underscoring the importance of improving patient education to ensure enhanced adherence to treatment. This study provides critical insights into the lived experiences of PLHIV using dolutegravir, offering valuable direction for future interventions aimed at improving adherence and optimising treatment outcomes in HIV care.
Contribution: The study provides context-specific insights into how PLHIV perceive and experience dolutegravir-based regimens. By uncovering both the drivers of acceptance and the hidden barriers to adherence, it offers actionable evidence to guide patient-centred ART counselling, inform policy decisions and strengthen HIV treatment programmes to achieve sustained viral suppression in similar settings.