Table 2.
Connections as presented in Fig. 2 and Additional file 1. The connection type represents the polarity of the connection. A positive connection type indicates that both elements evolve in the same direction (when element A increases, element B will increase too, and vice versa). A negative connection type indicates that both elements will evolve in the opposite direction (when element A increases, element B will decrease, and vice versa)
| From | To | Type |
|---|---|---|
| Acceptance of HIV status | Adherence | + |
| Acceptance of HIV status | Engagement and retention in care | + |
| Acceptance of HIV status | Priority given to treatment | + |
| Acceptance of HIV status | HIV status disclosure | + |
| Accessibility of health centre (including safety) | Engagement and retention in care | + |
| Adherence | Drug levels in body | + |
| Adherence counselling | Understanding of HIV infection and treatment | + |
| Adherence counselling | Readiness to start taking ART | + |
| Administrative and political barriers | Individual and community empowerment | - |
| Administrative and political barriers | Timely acting on unsuppressed viral load | - |
| Administrative and political barriers | Well-functioning supply chain | - |
| ART treatment approach / policy | Timely acting on unsuppressed viral load | ± |
| ART treatment approach / policy | Healthcare system workload | ± |
| ART treatment approach / policy | Correct prescribing practices | ± |
| ART treatment approach / policy | Required frequency of hospital visits | ± |
| ART treatment approach / policy | Competence of healthcare workers | ± |
| Assuring quality of ART | Efficiency of drug combination | + |
| Availability and quality of equipment | Timely acting on unsuppressed viral load | + |
| Availability of better drugs | Global effort to tackle HIVDR | - |
| Availability of better drugs | HIVDR selection | - |
| Community stigma and gossip | Engagement and retention in care | - |
| Community stigma and gossip | Distance to the healthcare centre | + |
| Community stigma and gossip | Self-stigmatisation | + |
| Community stigma and gossip | Healthcare provider stigma | + |
| Community stigma and gossip | Adherence | - |
| Community stigma and gossip | HIV status disclosure | - |
| Competence of healthcare workers | Timely acting on unsuppressed viral load | + |
| Competence of healthcare workers | Correct prescribing practices | + |
| Competence of healthcare workers | Adherence counselling | + |
| Competence of healthcare workers | Patient-provider relationship | + |
| Concerns about side effects of ART | Adherence | - |
| Concurrent disease and opportunistic infections | Feeling and looking ill | + |
| Concurrent disease and opportunistic infections | Pill burden | + |
| Concurrent disease and opportunistic infections | Drug-drug interactions | + |
| Concurrent disease and opportunistic infections | Healthcare system workload | + |
| Concurrent disease and opportunistic infections | Optimal absorption of drug | - |
| Correct prescribing practices | Efficiency of drug combination | + |
| Depression | Adherence | - |
| Depression | Priority given to treatment | - |
| Depression | Substance abuse | + |
| Distance to the healthcare centre | Accessibility of health centre (including safety) | - |
| Distance to the healthcare centre | Engagement and retention in care | ± |
| Drug levels in body | Viral load suppression | + |
| Drug levels in body | Side effects of ART | + |
| Drug prices | Resource allocation with focus on population | - |
| Drug-drug interactions | Optimal absorption of drug | - |
| Efficiency of drug combination | Viral load suppression | + |
| Engagement and retention in care | Adherence | + |
| Engagement and retention in care | Financial situation | - |
| Engagement in alternative care | Engagement and retention in care | ± |
| Engagement in alternative care | Optimal absorption of drug | - |
| Engagement in alternative care | Misinformation | ± |
| Engagement in alternative care | Adherence | ± |
| Engagement in risk behaviour | Transmission of HIV(DR) | + |
| Feeling and looking ill | Community stigma and gossip | + |
| Feeling and looking ill | Engagement and retention in care | ± |
| Feeling and looking ill | Priority given to treatment | + |
| Feeling and looking ill | HIV status disclosure | + |
| Feeling and looking ill | Concerns about side effects of ART | + |
| Financial situation | Accessibility of health centre (including safety) | + |
| Financial situation | Timely acting on unsuppressed viral load | + |
| Financial situation | Migration | - |
| Financial situation | Food insecurity | - |
| Financial situation | Priority given to treatment | + |
| Food insecurity | Adherence | - |
| Food insecurity | Optimal absorption of drug | - |
| Forgetfulness | Adherence | - |
| Gender inequality | HIV status disclosure | - |
| Gender inequality | Adherence | - |
| Gender inequality | Engagement and retention in care | - |
| Gender inequality | Lower social status | + |
| Gender inequality | Engagement in risk behaviour | + |
| Global effort to tackle HIVDR | HIVDR Funding | + |
| Global effort to tackle HIVDR | ART treatment approach / policy | + |
| Having examples of well-functioning ART | Community stigma and gossip | - |
| Having examples of well-functioning ART | Acceptance of HIV status | + |
| Healthcare provider stigma | Engagement and retention in care | - |
| Healthcare provider stigma | Adherence counselling | - |
| Healthcare system workload | Adherence counselling | - |
| Healthcare system workload | Tracing of PLHIV | - |
| Healthcare system workload | Correct prescribing practices | - |
| Healthcare system workload | Timely acting on unsuppressed viral load | - |
| Healthcare system workload | Well-functioning supply chain | - |
| Healthcare system workload | Competence of healthcare workers | - |
| Healthcare system workload | Patient-provider relationship | - |
| Healthcare system workload | Job satisfaction and motivation of healthcare workers | - |
| HIV status disclosure | Social support | ± |
| HIV status disclosure | Community stigma and gossip | + |
| HIV status disclosure | Engagement in risk behaviour | - |
| HIV status disclosure | Adherence | ± |
| HIV status disclosure | Engagement and retention in care | + |
| HIVDR Funding | HIVDR Research focus | + |
| HIVDR Funding | Stock availability of ART and reagents | + |
| HIVDR Funding | Availability and quality of equipment | + |
| HIVDR Funding | Resource allocation with focus on population | ± |
| HIVDR Funding | Need to show success of the ART programme | + |
| HIVDR Funding | Resistance (and subtype) testing | + |
| HIVDR Research focus | Availability of better drugs | + |
| HIVDR Research focus | ART treatment approach / policy | + |
| HIVDR Research focus | Required frequency of hospital visits | - |
| HIVDR Research focus | Resource allocation with focus on population | + |
| HIVDR selection | Global effort to tackle HIVDR | + |
| HIVDR selection | Viral load suppression | - |
| HIVDR selection | Transmission of HIV(DR) | + |
| HIVDR selection | Healthcare system workload | + |
| Hospital design | Community stigma and gossip | ± |
| Hospital design | HIV status disclosure | ± |
| Incentive to search for information | Understanding of HIV infection and treatment | + |
| Incentive to search for information | Misinformation | + |
| Individual and community empowerment | Timely acting on unsuppressed viral load | + |
| Individual education level | Understanding of HIV infection and treatment | + |
| Job satisfaction and motivation of healthcare workers | Well-functioning supply chain | + |
| Job satisfaction and motivation of healthcare workers | Timely acting on unsuppressed viral load | + |
| Linguistic issues | Adherence counselling | - |
| Lower social status | Engagement and retention in care | - |
| Lower social status | Community stigma and gossip | + |
| Lower social status | Healthcare provider stigma | + |
| Migration | Healthcare system workload | + |
| Migration | Well-functioning supply chain | - |
| Migration | Engagement and retention in care | - |
| Misinformation | Understanding of HIV infection and treatment | - |
| Misinformation | Community stigma and gossip | + |
| Misinformation | Engagement in alternative care | + |
| Misinformation | Engagement in risk behaviour | + |
| Need to show success of the ART programme | HIVDR Funding | + |
| Need to show success of the ART programme | Administrative and political barriers | + |
| Optimal absorption of drug | Drug levels in body | + |
| Patient-provider relationship | Understanding of HIV infection and treatment | + |
| Patient-provider relationship | Engagement and retention in care | + |
| Patient-provider relationship | Adherence counselling | + |
| Patient-provider relationship | HIV status disclosure | + |
| Peer support group | Required frequency of hospital visits | - |
| Peer support group | Understanding of HIV infection and treatment | + |
| Pill burden | Pill fatigue | + |
| Pill burden | Side effects of ART | + |
| Pill fatigue | Adherence | - |
| Priority given to treatment | Adherence | + |
| Priority given to treatment | Engagement and retention in care | + |
| Punitive laws for MSM and sex workers | Engagement and retention in care | - |
| Punitive laws for MSM and sex workers | Transmission of HIV(DR) | + |
| Punitive laws for MSM and sex workers | Community stigma and gossip | + |
| Punitive laws for MSM and sex workers | ART treatment approach / policy | - |
| Quality of data systems | Tracing of PLHIV | + |
| Quality of data systems | Well-functioning supply chain | + |
| Quality of data systems | Timely acting on unsuppressed viral load | + |
| Readiness to start taking ART | Adherence | + |
| Religious beliefs | Self-stigmatisation | + |
| Religious beliefs | Engagement in alternative care | + |
| Required frequency of hospital visits | Engagement and retention in care | - |
| Required frequency of hospital visits | Healthcare system workload | + |
| Resistance (and subtype) testing | Correct prescribing practices | + |
| Resource allocation with focus on population | ART treatment approach / policy | + |
| Resource allocation with focus on population | Adherence | + |
| Self-stigmatisation | Acceptance of HIV status | - |
| Self-stigmatisation | HIV status disclosure | - |
| Self-stigmatisation | Depression | + |
| Side effects of ART | Feeling and looking ill | + |
| Side effects of ART | Adherence | - |
| Side effects of ART | HIV status disclosure | + |
| Social obligations | Financial situation | - |
| Social obligations | Priority given to treatment | - |
| Social support | Adherence | + |
| Stock availability of ART and reagents | ART treatment approach / policy | + |
| Stock availability of ART and reagents | Timely acting on unsuppressed viral load | + |
| Stock availability of ART and reagents | Job satisfaction and motivation of healthcare workers | + |
| Stock availability of ART and reagents | Required frequency of hospital visits | - |
| Stock availability of ART and reagents | Adherence | + |
| Substance abuse | Forgetfulness | + |
| Timely acting on unsuppressed viral load | Efficiency of drug combination | + |
| Tracing of PLHIV | Engagement and retention in care | + |
| Tracing of PLHIV | Timely acting on unsuppressed viral load | + |
| Transmission of HIV(DR) | Efficiency of drug combination | - |
| Transmission of HIV(DR) | Healthcare system workload | + |
| Understanding of HIV infection and treatment | Self-stigmatisation | - |
| Understanding of HIV infection and treatment | Engagement in risk behaviour | - |
| Understanding of HIV infection and treatment | Incentive to search for information | - |
| Understanding of HIV infection and treatment | Engagement and retention in care | + |
| Understanding of HIV infection and treatment | Adherence | + |
| Understanding of HIV infection and treatment | Acceptance of HIV status | + |
| Understanding of HIV infection and treatment | Individual and community empowerment | + |
| Understanding of HIV infection and treatment | Priority given to treatment | + |
| Understanding of HIV infection and treatment | Community stigma and gossip | - |
| Understanding of HIV infection and treatment | Engagement in alternative care | - |
| Viral load suppression | HIVDR selection | - |
| Viral load suppression | Concurrent disease and opportunistic infections | - |
| Viral load suppression | Required frequency of hospital visits | - |
| Viral load suppression | Healthcare system workload | - |
| Viral load suppression | Transmission of HIV(DR) | - |
| War and disease outbreaks | Accessibility of health centre (including safety) | - |
| War and disease outbreaks | Timely acting on unsuppressed viral load | - |
| War and disease outbreaks | Well-functioning supply chain | - |
| War and disease outbreaks | Migration | + |
| Well-functioning supply chain | Peer support group | + |
| Well-functioning supply chain | Stock availability of ART and reagents | + |