Tshivhase, S. E.Makhado, L.Mabasa, Coddyliver2026-06-192026-06-192026-05-19Mabasa, C. 2026. Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province. . .https://univendspace.univen.ac.za/handle/11602/3245MPHDepartment of Public HealthMissed appointments remain a critical challenge in the effective management of HIV in South Africa. Antiretroviral therapy (ART) adherence remains a critical determinant of treatment success for people living with HIV (PLHIV), particularly in low resource and rural settings. In South Africa, despite expanded access to ART, suboptimal adherence continues to undermine efforts to control the epidemic. ART is important in reducing HIV-related morbidity and mortality through achieving 95-95-95 targets of the national strategic goal. This study aimed to explore the contributory factors to missed ART appointments at selected primary health care facilities in the Vhembe District, Limpopo Province. Objectives: The objectives of the study were to: • Explore the multifaceted barriers contributing to missed ART appointments among patients at selected primary health care facilities of Vhembe district, Limpopo province. • Identify effective strategies and interventions to improve ART adherence and reduce missed appointments among patients at selected primary health care facilities of Vhembe district, Limpopo province. Methods: A qualitative research design was employed using purposive sampling to recruit twelve participants who had previously missed ART appointments. Data were collected through semi-structured interviews and analyzed thematically. Ethical approval was granted from the University of Venda, community leaders and relevant health authorities. Results: Both the empirical and the narrative review findings revealed that missed appointments were influenced by factors such as socio-economic, emotional, cultural, and health system variables. Important barriers included transport challenges, food insecurity, employment constraints, emotional distress, fear of stigma and gossip, lack of confidentiality, negative staff attitudes, and reliance on traditional beliefs. However, participants expressed a strong commitment to adhering to their treatment, highlighting an imbalance between their willingness and the structural and emotional support available to them. Conclusion: The study concludes that missed ART appointments are not merely a result of patient non-compliance but reflect broader systemic and psychosocial barriers. Addressing these requires a multi-level, patient-centered strategy that incorporates mental health care, enhances clinic accessibility, promotes staff-patient relations, and strengthens community- based support network. The study outlined valuable insights for designing interventions to promote ART adherence and invited future research to include broader stakeholder perspectives. Significance of the Study: This study outlined the lived experiences of patients, barriers and strategies for Antiretroviral Therapy Appointment Adherence in Rural South Africa that provides a deeper understanding of the contextual and structural challenges influencing ART adherence in rural settings. It underwrites to the body of knowledge needed to inform responsive, people-centered health interventions. Recommendations: The study recommends that health facilities should implement structured appointment reminder systems through SMS, phone calls, and home visits, especially for high-risk patients. The integration of social workers with health care teams can assist in identifying and addressing the hidden social or family-related challenges. Clinics should also reduce waiting times, offer flexible operating hours, and improve staff training on confidentiality, empathy, and stigma reduction. Mental health services such as depression screening and trauma counselling should be made accessible within ART programs. Community-based organizations and peer support groups should be mobilized to provide treatment literacy, follow-up, and psychosocial support. Finally, structural interventions such as transport subsidies, mobile clinics, and food support for vulnerable patients are essential to reduce missed appointments and improve long-term ART adherence.1 online resource (xv, 80 leaves): color illustrations, color mapsenUniversity of VendaAdherenceUCTDAnti-Retroviral TreatmentChallengesLived experiencesMissed appointmentsPatientPrimary health careDissertationMabasa C. Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province. []. , 2026 [cited yyyy month dd]. Available from:Mabasa, C. (2026). <i>Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province</i>. (). . Retrieved fromMabasa, Coddyliver. <i>"Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province."</i> ., , 2026.TY - Dissertation AU - Mabasa, Coddyliver AB - Missed appointments remain a critical challenge in the effective management of HIV in South Africa. Antiretroviral therapy (ART) adherence remains a critical determinant of treatment success for people living with HIV (PLHIV), particularly in low resource and rural settings. In South Africa, despite expanded access to ART, suboptimal adherence continues to undermine efforts to control the epidemic. ART is important in reducing HIV-related morbidity and mortality through achieving 95-95-95 targets of the national strategic goal. This study aimed to explore the contributory factors to missed ART appointments at selected primary health care facilities in the Vhembe District, Limpopo Province. Objectives: The objectives of the study were to: • Explore the multifaceted barriers contributing to missed ART appointments among patients at selected primary health care facilities of Vhembe district, Limpopo province. • Identify effective strategies and interventions to improve ART adherence and reduce missed appointments among patients at selected primary health care facilities of Vhembe district, Limpopo province. Methods: A qualitative research design was employed using purposive sampling to recruit twelve participants who had previously missed ART appointments. Data were collected through semi-structured interviews and analyzed thematically. Ethical approval was granted from the University of Venda, community leaders and relevant health authorities. Results: Both the empirical and the narrative review findings revealed that missed appointments were influenced by factors such as socio-economic, emotional, cultural, and health system variables. Important barriers included transport challenges, food insecurity, employment constraints, emotional distress, fear of stigma and gossip, lack of confidentiality, negative staff attitudes, and reliance on traditional beliefs. However, participants expressed a strong commitment to adhering to their treatment, highlighting an imbalance between their willingness and the structural and emotional support available to them. Conclusion: The study concludes that missed ART appointments are not merely a result of patient non-compliance but reflect broader systemic and psychosocial barriers. Addressing these requires a multi-level, patient-centered strategy that incorporates mental health care, enhances clinic accessibility, promotes staff-patient relations, and strengthens community- based support network. The study outlined valuable insights for designing interventions to promote ART adherence and invited future research to include broader stakeholder perspectives. Significance of the Study: This study outlined the lived experiences of patients, barriers and strategies for Antiretroviral Therapy Appointment Adherence in Rural South Africa that provides a deeper understanding of the contextual and structural challenges influencing ART adherence in rural settings. It underwrites to the body of knowledge needed to inform responsive, people-centered health interventions. Recommendations: The study recommends that health facilities should implement structured appointment reminder systems through SMS, phone calls, and home visits, especially for high-risk patients. The integration of social workers with health care teams can assist in identifying and addressing the hidden social or family-related challenges. Clinics should also reduce waiting times, offer flexible operating hours, and improve staff training on confidentiality, empathy, and stigma reduction. Mental health services such as depression screening and trauma counselling should be made accessible within ART programs. Community-based organizations and peer support groups should be mobilized to provide treatment literacy, follow-up, and psychosocial support. Finally, structural interventions such as transport subsidies, mobile clinics, and food support for vulnerable patients are essential to reduce missed appointments and improve long-term ART adherence. DA - 2026-05-19 DB - ResearchSpace DP - Univen KW - Adherence KW - Anti-Retroviral Treatment KW - Challenges KW - Lived experiences KW - Missed appointments KW - Patient KW - Primary health care LK - https://univendspace.univen.ac.za PY - 2026 T1 - Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province TI - Factors influencing missed appointments amongst patients who are on anti-retroviral treatment at selected primary health care facilities of Vhembe district, Limpopo Province UR - ER -