Barriers and Facilitators to HIV Service Access and Treatment Adherence Among Women Living with HIV in Nueva Ecija: A Mixed-Methods Study

Edward D. Castro; Alday CL; Paet RR

Authors

Edward D. Castro Nueva Ecija University of Science and Technology
Alday CL Nueva Ecija University of Science and Technology
Paet RR Nueva Ecija University of Science and Technology

Keywords:

ART, health access, HIV adherence, women living with HIV, transportation barriers, stigma, self-efficacy, mixed-methods, Nueva Ecija, peer support

Abstract

This mixed-methods study explored the barriers and facilitators influencing access to HIV services and treatment adherence among women living with HIV (WLHIV) in Nueva Ecija. The study integrated quantitative data from 100 survey respondents and qualitative insights from 7 in-depth interviews to provide a comprehensive understanding of logistical, systemic, and psychosocial challenges in antiretroviral therapy (ART) adherence. Quantitative results showed that transportation and healthcare costs were the most significant barriers, with 68.3% of respondents reporting difficulty affording transport to clinics (M = 4.27, SD = 0.84) and over 55% citing financial strain in paying for HIV services. Service availability was also a concern, with long wait times (M = 3.64, SD = 1.11) and inconvenient hours (M = 3.34, SD = 1.22) limiting access. Fears of stigma and breaches of confidentiality further discouraged consistent care, with 53.2% worried about being recognized at healthcare facilities (M = 3.79, SD = 1.10). Despite these challenges, self-efficacy scores were notably high. Respondents expressed strong confidence in remembering to take medication (M = 4.42), following treatment plans (M = 4.27), and managing adherence even under stress (M = 4.08). However, social support remained a moderate concern (M = 3.77), underscoring the emotional and relational dimension of adherence. Qualitative findings reinforced these patterns, revealing themes such as transportation hardship, scheduling conflicts, emotional burden, stigma, and the need for supportive, nonjudgmental care. Participants highlighted the absence of nearby clinics, fear of disclosure, and discrimination from healthcare staff as major deterrents. At the same time, many were motivated by their roles as mothers, partners, and believers, emphasizing a deep personal commitment to treatment. Suggestions included expanding peer support groups, enhancing privacy protections, and training healthcare workers in empathy and confidentiality. Overall, the study identifies key structural and psychosocial barriers while recognizing the resilience of WLHIV. It calls for integrated interventions—including logistical support, stigma reduction, and community-based care models—to strengthen ART adherence and health equity in the region.

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