Social Science Programme / Community Attitudes to ART Study Project

Lead Research Organisation: MRC/UVRI Uganda Research Unit on AIDS


ART has recently become available in several parts of rural Uganda. Within the area of MRCs surveillance project in SW Uganda, we started to make free ART available at the study clinic since early 2004. Although the provision of this service is highly welcome, there are concerns about the impact the introduction of ART may possibly have on sexual risk behaviour not only of persons who receive ART but also of healthy individuals from the general public. Whilst the epidemiological impact of this development will only be felt after some years, it may be feasible to detect the influence on beliefs, attitudes and reported practises much earlier, and to use these data to inform public health messages that should be given when rolling ART out to larger parts of the population in Uganda.|Other possible attitudes and beliefs that may need to be addressed refer e.g. to biological effectiveness of ART (possible perception of ART as a cure for HIV infection), and issues of adherence, given the widespread practice of drug sharing within families.The MRCs social science research team held discussions with different groups from the population (and also conducted in-depth interviews with individuals from these groups) at the time when ART services became available. The groups differ by gender and by the degree to which they have access to ART. It is important to monitor ART related attitudes and beliefs over time. The MRC will repeat this research starting in 2008.

Technical Summary

Purpose: To investigate HIV risk perception, knowledge and attitudes related to antiretroviral therapy (ART) in rural communities at the onset of access to ART. To repeat this assessment once ART has been available for about 3 years, in order to assess trends in attitudes and impact of ART on risk perception.|Methods: Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted among men and women aged in their 30s and early 40s, the age groups most affected by HIV disease and likely to benefit most from the introduction of ART. Data collection took place around the time when ART was first introduced at the MRCs field study clinic in rural SW Uganda. FGDs were stratified by sex and by 3 categories designed to capture differential access to HIV-related health services. The group with greatest access was represented by members of the Rural Clinical Cohort (see separate abstract) who either receive ART or were being screened for ART eligibility. Intermediate access was represented by members of the General Population Cohort (GPC, see separate abstract) as they have access to MRC clinic services throughout the year. Those with least access were represented by residents from outside the MRC study area.|These data were supplemented by corresponding data from the annual questionnaire survey exercise that is being performed as part of the GPC project.|The field work conducted to collect baseline data has been completed. These data have been analysed. The field work for the follow-up assessment will commence early in 2008.
Description Influence ART delivery
Geographic Reach Africa 
Policy Influence Type Influenced training of practitioners or researchers
Description DFID Evidence for Action Research Programme Consortium
Amount £10,000 (GBP)
Organisation Government of the UK 
Department Department for International Development (DfID)
Sector Public
Country United Kingdom
Title qualitative database 
Description interview transcripts 
Type Of Material Biological samples 
Provided To Others? No  
Impact In the process of sharing with others for analysis and writing 
Description Jinja trial 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Department Faculty of Epidemiology and Population Health
Country United Kingdom 
Sector Academic/University 
PI Contribution The social science research was one component of this collaboration
Collaborator Contribution staff time
Impact There is a website for the trial -- details of outputs will be listed under the `Treatment and Care Programme' of the Unit
Description University of East Anglia 
Organisation University of East Anglia
Department School of International Development UEA
Country United Kingdom 
Sector Academic/University 
PI Contribution joint work on research
Collaborator Contribution Staff time
Impact papers and further research funding
Description Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Participants in your research and patient groups
Results and Impact Presentations

Interest in the research
Year(s) Of Engagement Activity 2006,2007,2008,2009