Ated issues’ is therefore prioritised within the following description of the themes, in order to highlight the unique contribution of this review.Mindachew (2011) [21]4 hospitals in Addis AbabaEthiopiaQuantitative cross sectional studyTheme one: Individual personal beliefsQuantitative ?clinical trial with follow up for adherenceMunseri (2008) [23]565 HIV-infected subjects in DarDar TB vaccine trialMuhimbili University of HealthTanzaniaQualitative and QuantitativeFive studies [20,23,24,25,26] described individual personal beliefs as core factors contributing to the adherence of IPT. Such individual personal “micro-level” beliefs include fear of INH side effects, understanding of IPT and its importance, and belief in INH safety. Three studies [24,25,26] focused on patients’ understanding of the effect and the repercussions of defaulting or not adhering to IPT treatment. Other related reasons include misunderstanding about the duration of IPT which also highlights the importance of counselling prior to enrolment [24]. However Ngamvithavapong and colleagues also observe that patients were successful in adhering even though they lacked accurate knowledge [24]. This is shown in the following statement: `Some of them [adherents] thought that Isoniazid reduced blood HIV concentration or that it prevents other AIDS-related complications’ [24]8 public health clinics in 2 largest BLU-554 cost cities in Botswana 2 HIV clinics in PietermaritzburgSzakacs (2006) [26]Botswana87 HIV-positive clinic 301 consecutive attendees HIV positive patients1995 PLWH recruited to trial and attending government clinicsSouth AfricaQuantitativeTheme two: HIV treatment and related AG-490 chemical information issuesHIV treatment and related issues such as concurrent use of HAART and denial of HIV status posed further contributing factors towards non-adherence to IPT. Patients in included studies reported feeling discouraged to take two regimens at the same time. They also described how they experienced toxicities, felt their disease was too advanced to be cured or did not want to be associated with the HIV “stigma” [20]. Denial or non-disclosure of HIV status was the most common of all sub-themes identified from the selected studies. This was a major theme in two studies [20,25], as fear of rejection and stigmatization prevented people from disclosing their HIV status or coming out for treatment. This is confirmed both by author interpretation and by direct quotations from participants: The reason for this difference may be that, in our setting, IPT is linked to HIV, and women in this study did not want their HIV status to be disclosed due to fear of separation from their spouses or families. [23] `It’s not good to tell anyone … because it’s spread all over the village. So I’ll be having a problem because I won’t be free when I go around. I’ll be afraid of the people’ (interrupter) [25] Beyond the influence of HIV related stigma, Rowe and colleagues draw upon a host of observations related to people’s understanding and interpretation of HIV/AIDS as an illness, what they call, `an individual’s health culture’ [25]. This relates to the perception of HIV/AIDS as incurable and the associated tension between people’s faith in western medicine on the one hand and traditional healing practices on the other, which especially come to a head in the case of such `fatal’ diseases [25].Bakari (2000) [19] Rowe (2005) [25]Bohlabela District HospitalTable 3. Study characteristics of included studies.Ngamvithayapong (199.Ated issues’ is therefore prioritised within the following description of the themes, in order to highlight the unique contribution of this review.Mindachew (2011) [21]4 hospitals in Addis AbabaEthiopiaQuantitative cross sectional studyTheme one: Individual personal beliefsQuantitative ?clinical trial with follow up for adherenceMunseri (2008) [23]565 HIV-infected subjects in DarDar TB vaccine trialMuhimbili University of HealthTanzaniaQualitative and QuantitativeFive studies [20,23,24,25,26] described individual personal beliefs as core factors contributing to the adherence of IPT. Such individual personal “micro-level” beliefs include fear of INH side effects, understanding of IPT and its importance, and belief in INH safety. Three studies [24,25,26] focused on patients’ understanding of the effect and the repercussions of defaulting or not adhering to IPT treatment. Other related reasons include misunderstanding about the duration of IPT which also highlights the importance of counselling prior to enrolment [24]. However Ngamvithavapong and colleagues also observe that patients were successful in adhering even though they lacked accurate knowledge [24]. This is shown in the following statement: `Some of them [adherents] thought that Isoniazid reduced blood HIV concentration or that it prevents other AIDS-related complications’ [24]8 public health clinics in 2 largest cities in Botswana 2 HIV clinics in PietermaritzburgSzakacs (2006) [26]Botswana87 HIV-positive clinic 301 consecutive attendees HIV positive patients1995 PLWH recruited to trial and attending government clinicsSouth AfricaQuantitativeTheme two: HIV treatment and related issuesHIV treatment and related issues such as concurrent use of HAART and denial of HIV status posed further contributing factors towards non-adherence to IPT. Patients in included studies reported feeling discouraged to take two regimens at the same time. They also described how they experienced toxicities, felt their disease was too advanced to be cured or did not want to be associated with the HIV “stigma” [20]. Denial or non-disclosure of HIV status was the most common of all sub-themes identified from the selected studies. This was a major theme in two studies [20,25], as fear of rejection and stigmatization prevented people from disclosing their HIV status or coming out for treatment. This is confirmed both by author interpretation and by direct quotations from participants: The reason for this difference may be that, in our setting, IPT is linked to HIV, and women in this study did not want their HIV status to be disclosed due to fear of separation from their spouses or families. [23] `It’s not good to tell anyone … because it’s spread all over the village. So I’ll be having a problem because I won’t be free when I go around. I’ll be afraid of the people’ (interrupter) [25] Beyond the influence of HIV related stigma, Rowe and colleagues draw upon a host of observations related to people’s understanding and interpretation of HIV/AIDS as an illness, what they call, `an individual’s health culture’ [25]. This relates to the perception of HIV/AIDS as incurable and the associated tension between people’s faith in western medicine on the one hand and traditional healing practices on the other, which especially come to a head in the case of such `fatal’ diseases [25].Bakari (2000) [19] Rowe (2005) [25]Bohlabela District HospitalTable 3. Study characteristics of included studies.Ngamvithayapong (199.