• Greeting (to create rapport with ARV user)
• Statement of confidentiality.

1. Sociodemographic information on informants

a) Sex
b) Age
c) Educational level (no education, primary, secondary, tertiary)
d) Who do you live with (spouse, children, house girl etc)?
e) Employment status (unemployed, self, government, NGO)
f) Distance from facility (in time or distance)

We would like to understand a bit about how it is for people taking ARVs. Could you tell me how you spend a normal day? How do you spend your spare time? What do you do to relax?

2. Medical history of patient

a)When where you first diagnosed?

b) What made you decide to go for testing?

c) When did you start treatment for HIV (HAART)?

d) How do you feel about your health since you started treatment?How would you describe your health since you started treatment?

• Better
• The same
• Worse

3. Patient knowledge about HIV/AIDS

We would like to understand what people actually know about the illness that they have. Can you tell me what you know about HIV/AIDS? (Allow patient to say what they want, then probe on the following: cause of HIV infection, cause of AIDS, prevention, life-long infection). Apart from this, is there anything else you may have heard from your community that explains AIDS in a different way?

4. Patient knowledge about ARVs

We would like to understand what people know about their treatment. Could you help us with this by telling me what you know about ARVs? (Allow patient to say what they want, then probe on the following: Prolongs life, Improves quality of life, Life long treatment, Knowledge about side effects.)

5. Assessment of adherence and non-adherence

We are trying to find out how patients manage to take their medicines - for some people it's not a problem, but we also know that others don't always find it easy. Please feel free to be open about the problems you face with this. Everything you say here will remain confidential, and will not be shared with anyone at the clinic.

a) Do you have your medicines with you? May I see them? Please can you tell me when you take each of the medicines? (Refer to table with sun and moon, or other checklist)

b) Are there any other medications you are taking (e.g. cotrimoxazole, herbs etc)

c) Over the last two days, when did you take your pills? (Not including today - from yesterday evening and back.)

d) Did you perhaps miss any? (Confirming (c), sympathetic manner. Details if yes.)

e) This is a very important question. We appreciate how difficult it can be to take pills on a daily basis. If you sometimes miss a dose, please can you tell me what causes this to happen? Can you give an example or two?

f) On the other hand, what is it that helps you to take your pills regularly and on time? (e.g. organizations, individuals, clock etc)

g) Have you disclosed your status to any one? If so, who? Do they help you to take your pills? [If not covered in (f)]

h) Have you had your treatment changed at any moment since you started on ART. If yes, why? (e.g Treatment failure, Side effects)

i) Have you ever missed an appointment at your ART clinic? (Reasons, and details on type of consultation: review/refill etc.)

j) What do you think happens in your body if you skip your ARV medication?

k) Have you ever thought about stopping ART? If yes, details.

6. Perception about HIV/AIDS, ARVs and stigma

Have you had any experience of being treated differently because of your HIV status?

7. Cost considerations

a) How much do you have to pay to cover your travel expenses when you visit the clinic?
b) What is the cost of registering at the clinic (if any)?
c) What is the cost of the ARV medicines that you take (if any)?
d) Do you lose any income as a result of your coming to the clinic?
e) Do you incur any other costs as a result of your taking ART?
f) Do you and your family have to give anything up in order to be able to pay for your ART?

8. Quality of care

a) What do you think of the service you receive at this clinic? (General, open- ended, and then prompt, as below: ask for details as necessary)

• Do you feel listened to?
• Are you given the chance to state your problems and ask questions?
• Are you treated with respect?
• Do you feel you can trust the health workers?
• Do you have privacy during consultation and counselling?
• How do you find the environment of the clinic?

b) How long did you spend altogether at the clinic when you last came for review?

c) How long did you have to wait before being attended to?

9. Perceived problems and possible solutions

a) What do you perceive as the biggest problem regarding taking ARV treatment?
b) What do you think could be done to improve this?

Have you any questions for me?

Thank you for your time and cooperation!