Table 3 Perceived facilitators and barriers to acceptance and completion of 3HP expressed in terms of their Behavioral determinants within the COM-B model
| Behavioral Determinants | Emergent themes | |
|---|---|---|
| PLHIV | Health workers | |
| Facilitators | ||
| Capability (psychological) |
• Aware of being potentially at risk of TB • Awareness of easy transmission of TB | • Knowledge that TB causes the highest mortality among PLHIV at the clinic |
| Opportunity (physical) | • Streamlined clinic visits | |
| Motivation (reflective) |
• Willingness to take TPT • Trust in health workers • Perceived benefits of DOT/SAT |
• PLHIV trust health workers • PLHIV are receptive to TPT • Convenience of once-weekly 3HP dosing schedule • Perceived benefits of DOT/SAT |
| Motivation (automatic) | • Fear of contracting TB | • PLHIV fear TB |
| Barriers | ||
| Capability (physical) | • Potential pill burden (difficulty to swallow many pills) |
• Technology challenges • Potential pill burden (difficulty to swallow many pills) |
| Capability (psychological) | • Inadequate understanding of TPT | • Inadequate understanding of TB and TPT |
| Opportunity (social) | • Stigma associated with TB | |
| Motivation (reflective) |
• Perceived challenges of DOT/SAT • Concerns about the effectiveness of 3HP | • Perceived challenges of DOT/SAT |
| Motivation (automatic) | • Fear of potential side effects | • PLHIV’s fear of potential side effects |