S/N Question No Yes
0 1
IB1 Has anybody ever looked at you differently because you have HIV and TB?
IB2 Has a hospital worker treated you wrongly because of your HIV and TB status?
IB3 Has a healthcare worker refused to touch you because you have HIV and TB?
IB4 Have you been told not to share your food or utensils with relatives because of your HIV and TB status?
IB5 Have you been asked not to touch or care for children because of your HIV and TB status?
IB6 Have you been refused medical care or denied hospital services because of your HIV and TB status?
IB7 Have family members forced you to move out of your home because you have HIV and TB?
IB8 Has someone threatened to hurt you physically because you have HIV and TB?
IB9 Has any hospital worker in this treatment centre treated you wrongly because of your HIV and TB status?
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APPENDIX II
IN-DEPTH INTERVIEW GUIDE FOR HEALTH CAREGIVERS
Place interview takes place
Name of person interviewed (optional) Title of interviewee
Name of interviewer Date of interview Time of interview
Good morning/afternoon. How is your work and the family? I hope all is well? My name is Boniface Ushie. I am a student in the University of Ibadan and I am currently undertaking research as part of the requirements for my graduation. I need your help to complete this research. This is the reason why I have invited you to participate in this interview. The research is trying to understand factors that enhances or hinders adherence to treatment among people who have both HIV and Tuberculosis. I depend on the information you will supply here to understand these factors. Let me make it clear to you that you are under no obligation to grant me this interview but doing so will help me tremendously. Information shared here will be treated in the strictest of confidentiality. Feel free to express your opinion about any issues as you see it. Do I have your permission to begin the interview?
Now, I will ask you some questions:
1. What is your experience with patients who are receiving treatment for HIV and Tb 2. What makes it difficult for patients to take their medication?
3. How often do you talk to them about their medicine?
What do you talk to them about?
4. What is your opinion about giving both HIV care and TB care in the same treatment facility?
Probe:
How will this be helpful to patients in adhering to treatment?
How will this be a barrier to adherence?
5. What are some of the reasons your patients often give for missing medication?
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Psychological factors
Social factors
Economic factors
6. Please tell me about your relationship with the HIV and TB patients Probe:
Do you often feel stigmatised for working with infected persons?
Will you consider them a difficult to care-for patients? How?
What kind of feelings do the patients arouse in you when taking care of them?
What are some of the challenges you encounter with HIV and TB patients?
7. What do you think is the best way to ensure patients achieve near perfect compliance with treatment recommendations?
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APPENDIX III
IN-DEPTH INTERVIEW GUIDE FOR FRIENDS AND FAMILY MEMBERS Good morning/afternoon. How is work and the family? I hope all is well? My name is Boniface Ushie. I am a student in the University of Ibadan and I am currently undertaking research as part of the requirements for my graduation. I need your help to complete this research. This is the reason why I have invited you to participate in this interview. The research is trying to understand factors that enhances or hinders adherence to treatment among people who have both HIV and Tuberculosis. I depend on the information you will supply here to understand these factors. Let me make it clear to you that you are under no obligation to grant me this interview but doing so will help me tremendously. Information shared here will be treated in the strictest of confidentiality. Feel free to express your opinion about any issues as you see it.
Place interview takes place Name of interviewee (Optional)
Educational background of interviewee Age
Occupation Marital status Ethnic group Title of interviewee Name of interviewer Date of interview Time of interview
Salutations and rapport building Now, please,
1. What do you know about the treatment for HIV and TB co-infection?
2. How do people in your culture or community think about HIV and TB?
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Causes
Treatment
3. What do you think or feel about people who are on HIV AND TB drugs?
Probe:
Do you think they are to blame?
4. Would you help a friend, family member or anyone who is infected with HIV and TB?
Probe:
What kind of help would you give?
What do you think is the best way of treating family members and friends who are on HIV and TB medication?
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APPENDIX IV
FOCUS GROUP DISCUSSION GUIDE FOR HIV AND TB CO-INFECTED PATIENTS
Place interview takes place Title of interviewee
Name of interviewer Date of interview Time of interview
Good morning/afternoon. How are you today? I believe you and your family are good? I hope all is well? My name is Boniface Ushie. I am a student in the University of Ibadan and I am currently undertaking research as part of the requirements for my graduation. I need your help in completing this research. This is the reason why I have invited you to participate in this interview. The research is trying to understand factors that enhances or hinders adherence to treatment among people who have both HIV and Tuberculosis. I depend on the information you will supply here to understand these factors. Let me make it clear to you that you are under no obligation to grant me this interview but doing so will help me tremendously. Information shared here will be treated in the strictest of confidentiality. Feel free to express your opinion about any issues as you see it during this discussion. I have come to you because I do not know about these things. Be candid in your opinion. Every of your opinion will be useful to me.
If you agree to be involved in this discussion, give me the permission to begin.
1. How do people feel about HIV and TB?
Probe:
What do you know about HIV and TB co-infection?
2. What makes patients want to take their medication?
Probe:
What are the benefits of taking medication?
3. What makes patients not want to take their medication?
Probe:
Are there risks to patients‘ health as a result of taking medication?
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What makes some patients feel that it is not worth it to keep taking the drugs
4. What are the benefits of giving HIV drug in the same place with TB drugs?
Probe:
Please tell me how this can helped to make getting treatment for HIV and TB easier?
What are the difficulties patients face because the treatment for HIV and TB are put together?
5. Who are those important people who can help people on treatment of HIV and TB infections?
Probe:
What kind of help can they provide?
In what ways do they relate with people living with HIV and TB that do not make them feel happy?
How would patients on drugs want to be treated by family members and friends?
6. Please tell me how people see HIV and TB in your culture.
Probe:
What do they think causes HIV AND TB?
Are there local ways of treating these illnesses?
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APPENDIX V
CASE HISTORY Place interview takes place
Title of interviewee Name of interviewer Date of interview Time of interview
Good morning/afternoon. How are you today? I believe you and your family are good? I hope all is well? My name is Boniface Ushie. I am a student in the University of Ibadan and I am currently undertaking research as part of the requirements for my graduation. I need your help in completing this research. This is the reason why I have invited you to participate in this interview. The research is trying to understand factors that enhances or hinders adherence to treatment among people who have both HIV and Tuberculosis. I depend on the information you will supply here to understand these factors. Let me make it clear to you that you are under no obligation to grant me this interview but doing so will help me tremendously. Information shared here will be treated in the strictest of confidentiality. Feel free to express your opinion about any issues as you see it during this discussion. I have come to you because I do not know about these things. Be candid in your opinion. Every of your opinion will be useful to me.
If you agree to be involved in this discussion, give me the permission to begin.
1. How did you know that you were infected?
2. What did you do when you became aware that you had been infected?
3. From the time you started treatment, what are the things that normally help you to carefully take your medicine as prescribed?
4. How do these things help you?
5. What are the problems you normally encounter in the process of taking your medicine?
6. Who are the important people who help make it easy for you to take your drugs regularly? How do they help?
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APPENDIX VI
PATIENTS’ HOSPITAL RECORD GUIDE
(To be completed by a NURSE or any other auxiliary staff of the hospital from Patients’
records) 1. Patient identification number ____________
2. Patient sex ____________
3. For what condition is this patient being treated in this treatment centre? __________
4. Is this patient being treated for any other infectious disease apart from HIV and TB?
_______
5. When was this patient registered for treatment in your clinic? ______________
6. How many times has the patient attended clinic since registration? _______
7. Has the patient failed to report for appointments at the appointed times?
8. If yes, estimate the number of days the patient could have gone without drugs.
__________
9. From the record, what was the patient‘s HIV condition at the time of registration?
___________
From the record, what is the patient‘s HIV condition now?
_________________
From the record, would you say that this patient has been adhering to medication? ________
What reason would you adduced for this? ___________
10. What was this patient‘s TB condition at the time of registration? ___________
From the record, what is the patient‘s TB condition now?
_________________
From the record, would you say that this patient has been adhering to medication? ________
What reason would you adduced for this? _____________________
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APPENDIX VII
Research Questionnaire Department of Sociology Faculty of the Social Sciences
University of Ibadan, Ibadan
Interviewer, please ensure that the respondent gives his/her consent before beginning the interview
S/N Question Response Value
a. Location Urban 1
Rural 2
b. Name of treatment centre ---
c. Type of treatment centre HIV Centre 1
TB Centre 2
HIV and TB Centre 3
d. Questionnaire number
e. Date of interview ___/______/____
Day/Month/Year f. Name of interviewer
g. Time of interview
h. Mode of administration Self
Interviewer Both
SECTION A: DEMOGRAPHIC INFORMATION Please circle or fill in response
No Questions Response Value Skip
A1. Interviewer:
Observe and record sex of respondent
Male 1
Female 2
A2. Wetin be your years since the time for your last birthday?
--- A3. Wetin be the name for the local
government where you dey stay now? --- A4. Which one be you bribe? --- A5. Wetin be the level of education wey
you get?
No formal school 0
Primary school 1
Junior secondary 2
Senior Secondary 3
Post secondary (specify)--- 4
Others (specify) 77
A6. You dey school now? No 0
Yes 1
A7. Wetin be your religion?
(Specify denomination) ---
Christianity 1
Islam 2
African traditional religion 3 Other(specify) ___________ 77
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A8. You get husband or wife? Single 1
Married 2
Cohabitation 3
Divorced 4
Separated 5
Widowed 6
A9. You get pikin? No 0 A13
Yes 1
A10. How many pikin you get? _________
A11. Wetin be the age of your first pikin? _________
A12. Wetin be the age of last pikin? _________
A13. Which work you de do?
A14. Wetin be the money wey you dey collect for every month?
N __________________
SECTION B: KNOWLEDGE OF HIV AND TB TREATMENT
S/N Question Responses Value Skip
B1 You dey drink any medicine for No Yes
a) HIV? 0 1
b) TB? 0 1
B2 You kow how you suppose drink your No Yes
a) HIV medicine? 0 1
b) TB medicine? 0 1
B3 You think say anytin fit happen if you no drink your medicine de way dem tell you?
No 0 B5
Yes 1
B4 If you gree say sometin fit happen, tell me the kin tin wey fit happen.
For question B5 go reach question B8, after every talk, tell me how you follow gree and how you follow no agree.
B5 If you drink medicine for the proportion wey dem tell you, e no good for sick person
No 0
Yes 1
B6 E no matter whether person drink the number of medicine dem tell am since na de
medicine dem tell am him drink.
No 0
Yes 1
B7 Medicine for HIV fit, cure TB sickness so if person dey drink HIV medicine the person no no need for drink TB medicine.
No 0
Yes 1
B8 Medicine for TB fit cure sickness for HIV, so if person dey drink medicine for TB the person no need drink HIV medicine.
No 0
Yes 1
B9 For the different medicine wey you dey drink you sabi the number of medicine you
suppose drink?
No 0
Yes 1
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for time to time?
No 0
Yes 1
B11 You think say anti-retroviral drugs fit cure HIV?
No 0
Yes 1
B12 You sabi say anti-retroviral medicine fit make person live long?
No 0
Yes 1
B13 You bin know say anti-retroviral medicine dey make person live long?
No 0
Yes 1
B14 Abi na think you de think say anti-retroviral medicine dey make person live long?
No 0
Yes 1
SECTION C: ADHERENCE TO TREATMENT
S/N Question Response Value Skip
C1. How many kin of medicine you dey drink for
a) HIV? ________
b) TB? _______
C2. How many tablets you dey drink one time for
a) HIV? _________
b) TB? ________
C3. How many tablets them say make you drink for so so time for
a) HIV? ________
b) TB? ________
C4 How many tablets you go wan take for so so time? ________
C5. How many times you dey drink your medicine for one day? ________
C6. How many times dem say make you drink your medicine for one day?
_______
C7. E get any time or day wey you know drink your medicine as dem tell you?
Never 0 C9
Yes 1
C8. How many times you kow fit drink your medicine for
a) 1-7 days?
---
b) 8-14 days?
---
c) pass 15 days?
--- C9. E get time when you drink your medicine but ne bi the time
you suppose drink am?
Never 0 C11
Yes 1
C10 .
Na for how many times this kin thing don follow happen.
a) 1-7 days?
b) 8-14 days?
c) Abi e pass 15 days?
C11 .
E get anything wey done do you no see doctor or nurse before?
No 0
Yes 1
C12 .
Na only when body no fine you na him you dey go hospital?
No 0
Yes 1
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Please circle one response for each question
S/N Questions Not at
All Sure
Somew hat Sure
Very Sure
D1. You sure say: 0 1 2
a) You drink all your medicine the way dem tell you?
b) You go drink your medicine as dem tell you?
c) The medicine dem fine for your body?
d) the medicine dem go dey fine for your body e) You think say if you no drink your medicine as dem tell you, your body no go strong?
f) You fit help your body to strong?
g) You fit drink your medicine as dem tell you?
SECTION E: INTERACTION WITH TREATMENT CENTRES E1. Which kin sickness dey make you come here? HIV 1
TB 2
HIV and TB 3
E2. For which kin time you don dey drink HIV medicine?
___________
E3 For which kin time you don dey drink medicine for TB?
___________
E4. For which kin time you don dey collect medicine from this place?
___________
E5. Na only this place you dey come for treatment?
No 0
Yes 1 E7
E6. If you say No for the question before, which place you dey go again?
___________
E7. Na who dey talk with you when you come for this place?
Doctor 1
Nurse 2
Other
(Specify)_______
77 E8. Na the only time wey dem say make you
came na him you dey see doctor and nurse?
No 0
Yes 1
E9. You get time wey dem say make you dey come here?
No 0
Yes 1
E10. Na when you medicine finish na him you dey come here?
No 0 E12
Yes 1
E11. If you say yes, you dey come when your medicine won finish you dey come or na wen e don finish kpatakpata?
When drugs are about to finish
1 when drugs have
finished
2 E12. How many deys e dey take for you to come
when your medicine finish.
________________
E13. E get the time wey you no fit get medicine because e done finish?
Yes 0 E15
No 1
E14. If you no get medicine here, wetin you dey I go to another clinic 1
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do? I go back home 2
E15. The doctor and nurse they look you eye well well?
No 0
Yes 1
E16. You think say doctor and nurse dey look you wey get HIV and TB well well like the people wey e no get TB and HIV?
No 0
Yes 1
E17. You think say the doctor and nurse fit look you well well?
No 0
Yes 1
E18. How many times doctor and nurse dey talk about your body?
Not at all 0
Rarely 1
Frequently 2
Always 3
E19. Dem dey tell you well well how and the time to drink your medicine?
No 0
Yes 1
E20. Dem dey take time tell how e go good if you take your medicine well well?
No 0
Yes 1
E21. Dem done tell you before about the thing won fit happen when you drink your medicine?
No 0
Yes 1
E22. If fit tell people wey got TB and HIV mey them come see the doctor and nurse wey dey treat you?
No 0
Yes 1
E23. E get anytime wey people for your area bring medicine and tell you mey you drink?
No 0 E25
Yes 1
E24. If gree, you like am? No 0
Yes 1
No response 99
E25. If you no gree, you kike somebody for your area to dey come greet you?
No 0
Yes 1
SECTION F: COST
F1. The place wey you live far from here No 0
Yes 1
F2. How e far? _____________
I do not know 88
F3. You fit wake come here or you must enter motor or okada?
Only a walking distance 1 F6 Need to take
taxi/motorcycle
2 F4. Na how much you dey pay motor come here?
N ---
F5. You get that kin money? No 0
Yes 1
F6. You dey pay for the medicine wey dem dey give you for this place?
No 0 F9
Yes, all the time 1
Yes, some of the time 99
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a) Tests? N ---
b) Medicine?
F8. You fit pay for the tests and the medicine you dey collect?
No 0
Yes 1
F9. Government dey give una medicine for this place for dash?
No 0
Yes 1
F10. Remove government, e get another people wey dey give una medicine?
Myself 1
Friends 2
Family 3
Charity 4
NGO 5
F11 You dey buy food and water wit your money anytime you come here?
No 0 F13
Yes 1
F12 How much you dey spend for food and water
anytime you come here? ____________________
F13 You no go work sake of say you wan come here before?
No 0 F15
Yes 1
F14 How much done thowey for work or business
sake of say you dey drink medicine? _____________________
F15 Sake of say you dey drink medicine you no fit go work or do business?
No 0 G1
Yes 1
F16 How much money done throwey for work or
business sake of say you dey drink medicine? ______________________
SECTION G: TIME AND SCHEDULING OF DRUGS IN-TAKING Please circle one response for each question.
S/N QUESTION Never Rarely Sometimes Often
G1. For months wey don pass, how many times you don miss to drink your medicine sake of say:
0 1 2 3
a) You been no dey house?
b) You been dey do somethin?
c) You forget?
d) Medcine been too plenty to drink?
e) No wan take sake of say you dey fear another thin way fit happen?
f) You bin no wan people know say you dey drink bad sickness medicine?
g) The thing wey you dey do everyday change?
h) You bin dey fear say the medicine fit wound you?
i) Bin dey sleep when I suppose drink my medicine?
j) You bin sick?
k) You bin no happy?