Public sector antiretroviral treatment: the challenge of patient retention

Compliance with follow-up is needed to ensure that the public sector antiretroviral treatment programme in South Africa is successful and sustainable. This paper investigates the nature of factors associated with the retention of public sector ART patients in the primary health care-driven model. Data from a cross-sectional survey among patients are used. Income and social support are important facilitators of patient retention. Yet, income may also impact negatively on patient retention where entire families rely on a single breadwinner for their livelihood. Substance and alcohol abuse and stigma, according to the evidence, may impede patient retention. Avenues for further research are proposed and suggestions are put forward as to possible solutions to these policy dilemmas.