1. -IAA 1 Exit Interviews Adherence Assessment Survey Exit 1

2. -IAA Purpose The main reason is to ask for self report on adherence But interview will also check for— how long patient spent at the clinic how long patient took to travel to the clinic and how much it cost how many of the patient’s prescribed ARVs and other drugs were actually dispensed whether the medicines are correctly labelled whether the patient knows how to take the medicine correctly These questions provide information on possible determinants of adherence Exit 2

3. -IAA Sampling Convenience sample Goal: 30 interviews of patients who are on ART as they leave the clinic (except those who started on the day of data collection) If there are less than 30 patients that day, then all should be interviewed Each interview takes approximately 10 minutes; therefore, if patients come in a rush, it will be necessary for different numbers of data collectors to be interviewing at different times of day Exit 3

4. -IAA Location The last point of call for the patient is usually the dispensary It is challenging to find a suitable place for the interviews because it should be— Close to the dispensary Afford enough privacy Allow interviewer and interviewee to sit down Have enough space so that more than one interview at a time can be conducted Exit 4

5. -IAA How to Behave It is important to be pleasant and polite You should speak in a language well known to the patient—do not be officious, dress in a white coat, or speak with technical words You must put the patient at ease if you wish to get real information The main point is to build a trust so that when you get to the final questions on whether the patient has missed any doses in the last three days, he or she they will give you an honest answer Exit 5

6. -IAA The Exit Interview—Introduction The patient is under no obligation to speak to you, so it is important to introduce yourself with the important points You are working with the MOH to try and help to improve services for people taking ARVs It will only take a few minutes It is confidential. No harm or change will follow to the patient or clinic staff as a result of participation The patient may stop the interview at any time Exit 6

7. -IAA A Typical Introduction “Good Morning. My name is……… and I’m working with the Ministry of Health to try and help to improve services for ARVs in the country. I would like to speak to you for a few minutes about your experience in the clinic today and the medicines you are taking. All the information you give me will be entirely confidential so no one will know identities. It shouldn’t take more than 10 minutes. Would you mind speaking with me?” EVERYONE SHOULD PRACTICE THIS IN LOCAL LANGUAGE Exit 7

8. -IAA Exit Interview Form Take the manual (Chapter 4) and go over filling in the form, column by column Discuss how this would be asked in local language Discuss what to write down Have two volunteers role play the interview in front of everyone. Split into pairs and interview each other Keep doing the exercises until everyone has a uniform way of asking the questions and is comfortable with the procedures Exit 8

9. Exit Interview Form-1 DATA COLLECTION FORM: EXIT INTERVIEWS Date Facility # ABCDEF Pt # Age in Yrs Gender M / FOccupation Normal activity Y / N Months on trt. 1 2 3 Using chapter 4 of the manual to guide you, go through the guide to filling in the top of the form and each of the columns Exit 9

10. Exit Interview Form -2 Facility Name __________________ ___ HIJKLMN Cost home to clinic Time Home to clinic (in mins) Time in Clinic today (in mins) All ARVS dispensed Y/ N All Non ARVS dispense d Y / N All ARVs well labelled Y/N All other Meds well labelled Y / N Exit 10

11. -IAA Exit Interview Form -3 DATA COLLECTION FORM: EXIT INTERVIEWS side 2 OPQR Name of first ARV in patient regimen # times per day pt knows # times per day Y/N # Doses missed in last 3 days Exit 11

12. Exit Interview Form 4 AH Codes for Column AG 1 = Toxicity-side effect 2 = Shared with others 3 = Forgot 4 = Felt better 5 = Too ill 6 = Stigma 7 = Drug out of stock 8 = Patient ran out of pills or lost them 9 = Travel problems 10 = Inability to pay 11 = Alcohol 12 = Depression 13 = Took Holy Waters 14 = Fasting 15 = Change regimen 16 = Other (specify column AG) Exit 12

13. -IAA Exit Interview Form AFAG Reason for Missing doses (Code 1-15) If "Other," then specify reason for missing doses Exit 13