This was a cross-sectional descriptive study that set out to explore the factors affecting
adherence to antiretroviral therapy (ART) by people living with HIV and AIDS (PLWHA) in
Siaya County. The study examined the various costs associated with adherence to ART
including costs of treatment of opportunistic infections, transport to health facilities and
nutrition. The study also examined how stigma, cultural and religious beliefs and social
support affected PLWHA‟s adherence to ART. The study population consisted of PLWHA
who were aged 18 years and above and were enrolled in ART. The study was guided by the
behavioural model of health services use and Sweat and Denison‟s model of HIV and AIDS
structural factors. The research was conducted from June, 2014 to December, 2015.
Qualitative methods of data collection, including in-depth interviews, focus group
discussions, case narratives, key informant interviews and direct observation, were used. The
sample population comprised 210 PLWHA. Data were analysed using the ATLAS-ti
computer software. The findings reveal that poverty, stigma, cultural and religious beliefs and
lack of social support hampered PLWHA‟s adherence to ART in Siaya County. The findings
indicate that the majority of PLWHA did not afford the costs of medication for opportunistic
infections, transport to health facilities and nutritious diet, all of which are important for
successful adherence to ART. The study also established that adherence levels to ART for
PLWHA who received social support from healthcare workers, family members,
communities, friends, treatment partners, and other support groups was higher compared to
those who did not receive any. The study concludes that the costs associated with adherence
to ART including the cost of treating opportunistic infections, transport to health facilities
and nutrition hindered PLWHA‟s adherence to ART. In addition, stigma, cultural and
religious beliefs and lack of social support also affected PLWHA‟s adherence to ART
negatively. The study also concludes that availability of social support promoted adherence to
ART. Despite the potential for ART to bring positive health outcomes, the study found that
non-adherence to treatment had negative socio-economic impacts on PLWHA in Siaya
County. Non-adherence implies that PLWHA are as of yet, to enjoy the full benefits of free
ARV drugs provided by the government of Kenya. Findings from this study provide deep
insights into how poverty, stigma, religious and cultural beliefs and lack of social support
have undermined the government‟s effort to curb the spread and negative health impacts of
HIV in Siaya County. The study recommends that prudent strategies be put in place to
address the problem of HIV and AIDs related stigma and that PLWHA be sensitized on
negative cultural and religious beliefs which are detrimental to their health and the health of
the other members of the community in general. The study also recommends an
establishment of an online data base for all PLWHA enrolled in ART in all health facilities in
the Country to curb against PLWHA who move from one health facility to another after
defaulting in treatment and also to account for each and every PLWHA who is enrolled in
ART in terms of adherence and treatment progress. Finally, the PLWHA should be
economically empowered through the creation of employment and business opportunities as
well as safety net programmes to enable them deal with treatment-related costs including
medical insurance.