Table 3.

Reasons for treatment interruption (in-depth interviews; n=26)

Categories	Definition	Illustrative quotes
Travel (n=16)
Family related	Patient was travelling far in order to support family members. The distance to the clinic caused the treatment interruption.	I went to a funeral in Balaka, but failed to come back on time because I didn't have transport money. (Female, 22 years)
Work related	Patient was travelling far because of any kind of work, a job opportunity or assignment. The distance to the clinic caused the treatment interruption.	Since I am a labourer, I went to Dzalanyama to collect firewood, unfortunately had a car breakdown, slept there and did not carry my medicine. (Male, 44 years)
Financial barriers (n=7)
Transport cost	The patient could not afford the transport to the health centre, because of the distance and/or the lack of money.	Sometimes I even lack transport to come here from Chinsapo to collect my medication. (Female, 23 years)
Own health related (n= 6)
Adverse drug effects	The patient suffered from strong adverse effects of ART. He/she stopped treatment in order to improve his/her well-being.	I was having rashes, dizziness, stomach-ache and swollen legs (Female, 26 years)
Weakness/Sickness	The patient suffered from any symptoms not necessarily related to ART. He/she stopped because of illness.	I stopped because I was sick; had terrible headache and coughing (Female, 24 years)
Pregnancy/delivery	The patient was pregnant and or delivered a baby when she was supposed to collect drugs from LH/MPC. Her special condition detained her from collecting the drugs.	That time I had just delivered this baby so had no strength to walk to here. (Female, 33 years)
Health provider related (n=8)
Perceived rejection to receive ART re-fill	The patient felt/was told not to fulfil the requirements to collect ART at the centre. He/she therefore avoided going to the health centre.	I lost my health passport book through robbery. […] I thought that I could not be helped without this book. (Female, 42 years)
Disturbed relationship to health care provider	The patient experienced/perceived difficulties collecting new drugs from the health centre. He/she therefore avoided going to health centre.	I was afraid I could be shouted at by the Doctor (Female, 22 years)
General adherence (n=1)
Treatment fatigue	The patient was overwhelmed by the challenge to adhere to ART. He/she gave up and stopped therapy.	Laziness, and sometimes I take the medication without food, which raises fears in me. (Female, 23 years)