F personal experience with multiple layers of meaning. However, the methodology did have certain limitations, which are outlined here. Firstly, the research would have been strengthened by in-depth interviews with participants to provide further insight into the significance and meaning of their stories. Secondly, there was a shortage of male participants; we suggest that future research projects use innovative recruiting techniques such as recruiting in workplace settings or at taxi ranks and shebeens (informal drinking taverns) to attempt to give further voice to male perceptions of adherence in this community. Thirdly, our focus was limited to medication adherence rather than broader concepts of adherence to treatment and care, although in the end much broader ideas about the lived experience of HIV and other illnesses came out in the process. Fourthly, the stories that were shared could have been recalled from any time; some stories might relate to the distant past and some to much more recent memories. This makes it somewhat difficult to identify the real, on going adherence challenges that are occurring right now. Lastly, generalizability could be a challenge since the local community has been exposed to Africa Centre’s health communication campaigns for many years and is probably more literate about HIV and adherence than in other areas.PLOS ONE | DOI:10.1371/journal.pone.0148801 February 29,15 /Understanding Bay 41-4109 structure Specific Contexts of Antiretroviral Therapy AdherenceConclusionIn conclusion, our inductive thematic analysis of twenty digital story texts, soundtracks and drawings provided pertinent insights into the nature of adherence in this resource poor, rural community and helped to identify potential barriers and facilitators for those on lifelong treatment. Many of the stories gathered in this study reflect a growing confidence in the effectiveness of ART at both the individual and the community level. This sense of agency and hope should be acknowledged as a key facilitator in successful adherence. The stories highlighted the complexity of the issues that individuals and households face as they deal fpsyg.2017.00209 with HIV and ART in this setting and suggest that `simple’ biomedical responses to improving adherence may have limited impact [33], Certainly, the narratives make it clear that HIV has taken jir.2012.0140 a considerable toll on local communities and that an overburdened local healthcare system has often struggled to meet the needs and wants of a population suffering the consequences of a rapidly expanding HIV epidemic and to provide the necessary medical and emotional support. Moreover, poverty, evident in the lack of transport to seek medical care and in poor social support, can serve as a further structural barrier to accessing care and adhering well to medications. Lastly, it is important to note that although disclosure is a key step on the path to good adherence, the drawings that accompany some of the stories make it clear that disclosing one’s status can be very difficult. Health interventions that encourage disclosure should ensure that appropriate psycho-social GDC-0084 manufacturer support is provided. Our analysis of the stories suggests several opportunities for further research and the design of novel health interventions to support optimal adherence. First, the acknowledgment by several storytellers that HIV is much like other chronic diseases suggests that we could use the knowledge accumulated through several years of research into ART adherence to desi.F personal experience with multiple layers of meaning. However, the methodology did have certain limitations, which are outlined here. Firstly, the research would have been strengthened by in-depth interviews with participants to provide further insight into the significance and meaning of their stories. Secondly, there was a shortage of male participants; we suggest that future research projects use innovative recruiting techniques such as recruiting in workplace settings or at taxi ranks and shebeens (informal drinking taverns) to attempt to give further voice to male perceptions of adherence in this community. Thirdly, our focus was limited to medication adherence rather than broader concepts of adherence to treatment and care, although in the end much broader ideas about the lived experience of HIV and other illnesses came out in the process. Fourthly, the stories that were shared could have been recalled from any time; some stories might relate to the distant past and some to much more recent memories. This makes it somewhat difficult to identify the real, on going adherence challenges that are occurring right now. Lastly, generalizability could be a challenge since the local community has been exposed to Africa Centre’s health communication campaigns for many years and is probably more literate about HIV and adherence than in other areas.PLOS ONE | DOI:10.1371/journal.pone.0148801 February 29,15 /Understanding Specific Contexts of Antiretroviral Therapy AdherenceConclusionIn conclusion, our inductive thematic analysis of twenty digital story texts, soundtracks and drawings provided pertinent insights into the nature of adherence in this resource poor, rural community and helped to identify potential barriers and facilitators for those on lifelong treatment. Many of the stories gathered in this study reflect a growing confidence in the effectiveness of ART at both the individual and the community level. This sense of agency and hope should be acknowledged as a key facilitator in successful adherence. The stories highlighted the complexity of the issues that individuals and households face as they deal fpsyg.2017.00209 with HIV and ART in this setting and suggest that `simple’ biomedical responses to improving adherence may have limited impact [33], Certainly, the narratives make it clear that HIV has taken jir.2012.0140 a considerable toll on local communities and that an overburdened local healthcare system has often struggled to meet the needs and wants of a population suffering the consequences of a rapidly expanding HIV epidemic and to provide the necessary medical and emotional support. Moreover, poverty, evident in the lack of transport to seek medical care and in poor social support, can serve as a further structural barrier to accessing care and adhering well to medications. Lastly, it is important to note that although disclosure is a key step on the path to good adherence, the drawings that accompany some of the stories make it clear that disclosing one’s status can be very difficult. Health interventions that encourage disclosure should ensure that appropriate psycho-social support is provided. Our analysis of the stories suggests several opportunities for further research and the design of novel health interventions to support optimal adherence. First, the acknowledgment by several storytellers that HIV is much like other chronic diseases suggests that we could use the knowledge accumulated through several years of research into ART adherence to desi.