Factors influencing men to discontinue antiretroviral at Seventh Day Adventist clinic, Maseru, Lesotho.

Background: Discontinuation of ARV is a worldwide problem, with a discontinuation rate of 20% globally and 40-50% in Sub-Saharan Africa. In Lesotho, it ranges from 20 to 30% in men. To effectively tackle the HIV/AIDS epidemic in Lesotho, it is necessary to address the several complex problems that hinder adherence to ARVs among men. Methods: This study used a qualitative descriptive case study approach to collect data from men aged 18 years and above receiving health services at the Seventh-day Adventist clinic, using a homogeneous purposive sampling method. In-depth interviews were used to collect audio-recorded data after obtaining informed consent and 10 men who were on ART were interviewed. Results: Of the 10 clients, all had discontinued their ARVS in the past year (2023). Overall, participants identified four factors that influence most men to default on their ARVs: individual, socio-economic, culturally related, and health systems factors. Conclusion: Participant's difficulties, such as socio-economic obstacles (e.g., transportation costs and unstable employment), cultural influences based on religious and Christian norms that discourage clinic attendance, and deficiencies in the health system (e.g., lengthy wait times and rigid services) were identified by participants as interrelated factors driving men's discontinuation of ART treatment. These results necessitate that health systems take immediate, comprehensive actions, such as prioritising male-specific ART delivery modalities.