Table 3. Barriers and facilitators of HIV SMS program: qualitative findings.
| Major theme | Sub-theme | Direct or indirect quotes |
|---|---|---|
| Domain: barriers to program participation | ||
| Lack of awareness of PACTE-VIH program | Does not associate messages with services | Most participants: received messages but did not associate with PACTE-VIH program; received messages but did not know where they came from; received messages but did not know where to go for services. ‘Yes I receive messages, but I don’t know where they come from…’ (Interviewee 9) |
| Role of peer educators | Poor preparation to discuss HIV topics | Participants mentioned many instances of poor facilitation and sessions with disruptive elements not well managed by peer educators |
| Program functionality | Stopped receiving messages | Participants did not understand how the program functioned with respect to SMS, many stopped receiving messages and did not know how to re-enroll in the SMS program. ‘… I stopped receiving messages and do not know why? … there is no way to get back in the program’ (Interviewer 3); ‘… no way to clear opting in/out of messaging after a period’ (Interviewee 4) |
| Affordability | Referral services | Many did not have resources to pay for referral services and simply did not go. When referrals were needed, affordability was a constraint to sick care |
| Domain: facilitators to program participation | ||
| Increasing education/awareness | Perceived benefits and usefulness of messages | Many expressed increased knowledge about HIV risk, prevention and treatment, thus clearly acknowledging the benefits of the SMS program. ‘… I can also share […] that knowledge with my friends’ (Interviewee 7) |
| Location of HIV testing | – | Receipt of condoms and lubricants at testing location; timely service provision |
| Confidentiality | Establishing a UIC | Establishing the UIC was viewed as an important confidentiality factor. ‘… I would say that the UIC is better than directly writing your name … and so, I think the code suits us much more’ (Interviewee 1) |
| Perceived benefits of services offered | Being taking care at the drop-in center | Most that used services felt that someone cared about them at drop-in centers. ‘… I don’t have enough courage to get injections, but providers try to take away our fear and give us confidence, elsewhere providers are not patient, with slightest provocation tell you to leave if you hesitate treatment, and that they are not there for you’ (Interviewee 2) |
| Message frequency | – | Most participants favored the message frequency of the program, especially the message reminders to take medication. ‘… I think they should be sent frequently to encourage more people what are on medication to actually take it. … also, keep reminding us to protect ourselves so that we don’t get infected’ (Interviewee 6) |
HIV, human immuno-deficiency virus; SMS, short message system; UIC, unique identification code.