Barriers and facilitators of retention in HIV care and treatment services in Iringa, Tanzania: the importance of socioeconomic and sociocultural factors.
Identifieur interne : 000B85 ( PubMed/Checkpoint ); précédent : 000B84; suivant : 000B86Barriers and facilitators of retention in HIV care and treatment services in Iringa, Tanzania: the importance of socioeconomic and sociocultural factors.
Auteurs : Cecilia Tomori [États-Unis] ; Caitlin E. Kennedy ; Heena Brahmbhatt ; Jennifer A. Wagman ; Jessie K. Mbwambo ; Samuel Likindikoki ; Deanna L. KerriganSource :
- AIDS care [ 1360-0451 ] ; 2014.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (), Accessibilité des services de santé (), Adulte, Adulte d'âge moyen, Agents antiVIH (usage thérapeutique), Connaissances, attitudes et pratiques en santé, Culture (sociologie), Entretiens comme sujet (), Facteurs socioéconomiques, Femelle, Humains, Infections à VIH (traitement médicamenteux), Mâle, Médecine traditionnelle africaine (), Pauvreté (), Stigmate social, Tanzanie.
- MESH :
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- Acceptation des soins par le patient, Accessibilité des services de santé, Adulte, Adulte d'âge moyen, Connaissances, attitudes et pratiques en santé, Culture (sociologie), Entretiens comme sujet, Facteurs socioéconomiques, Femelle, Humains, Mâle, Médecine traditionnelle africaine, Pauvreté, Stigmate social, Tanzanie.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (therapeutic use), Culture, Female, HIV Infections (drug therapy), Health Knowledge, Attitudes, Practice, Health Services Accessibility (statistics & numerical data), Humans, Interviews as Topic (methods), Male, Medicine, African Traditional (methods), Middle Aged, Patient Acceptance of Health Care (statistics & numerical data), Poverty (statistics & numerical data), Social Stigma, Socioeconomic Factors, Tanzania.
- MESH :
- chemical , therapeutic use : Anti-HIV Agents.
- geographic : Tanzania.
- drug therapy : HIV Infections.
- methods : Interviews as Topic, Medicine, African Traditional.
- statistics & numerical data : Health Services Accessibility, Patient Acceptance of Health Care, Poverty.
- Adult, Culture, Female, Health Knowledge, Attitudes, Practice, Humans, Male, Middle Aged, Social Stigma, Socioeconomic Factors.
Abstract
Although an increasing number of people living with HIV (PLHIV) in sub-Saharan Africa are benefiting from the rapid scale-up of antiretroviral therapy (ART), retention in HIV care and treatment services remains a major concern. We examined socioeconomic and sociocultural barriers and potential facilitators of retention in ART in Iringa, Tanzania, a region with the second highest prevalence of HIV in the country. In 2012, 116 in-depth interviews were conducted to assess community members' perceptions, barriers and facilitators of HIV treatment in Iringa, including key informants, persons at heightened risk for infection, and HIV service-delivery users. Data were transcribed, translated, entered into Atlas.ti, coded, and analyzed for key themes. In order to provide the full range of perspectives across the community on issues that may affect retention, we report findings from all 116 participants, but draw on verbatim quotes to highlight the experiences of the 14 PLHIV who reported that they were receiving HIV care and treatment services. Despite the growing availability of HIV care and treatment services in Iringa, participants reported significant barriers to retention, including lack of knowledge and misperceptions of treatment, access problems that included difficulties in reaching distant clinics and pervasive poverty that left PLHIV unable to cope with out-of-pocket costs associated with their care, persistent stigmatization of PLHIV and frequent reliance on alternative healing systems instead of biomedical treatment. Positive perceptions of the efficacy of ART, improved ART availability in the region, improved access to care through supplemental aid, and social support were perceived to enhance treatment continuation. Our findings suggest that numerous socioeconomic and sociocultural barriers inhibit retention in HIV care and treatment services in this setting. Intervention strategies that improve ART accessibility, incorporate supplemental aid, enhance social support, reduce stigma, and develop partnerships with alternative healers are needed to improve HIV-related outcomes.
DOI: 10.1080/09540121.2013.861574
PubMed: 24279762
Affiliations:
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We examined socioeconomic and sociocultural barriers and potential facilitators of retention in ART in Iringa, Tanzania, a region with the second highest prevalence of HIV in the country. In 2012, 116 in-depth interviews were conducted to assess community members' perceptions, barriers and facilitators of HIV treatment in Iringa, including key informants, persons at heightened risk for infection, and HIV service-delivery users. Data were transcribed, translated, entered into Atlas.ti, coded, and analyzed for key themes. In order to provide the full range of perspectives across the community on issues that may affect retention, we report findings from all 116 participants, but draw on verbatim quotes to highlight the experiences of the 14 PLHIV who reported that they were receiving HIV care and treatment services. Despite the growing availability of HIV care and treatment services in Iringa, participants reported significant barriers to retention, including lack of knowledge and misperceptions of treatment, access problems that included difficulties in reaching distant clinics and pervasive poverty that left PLHIV unable to cope with out-of-pocket costs associated with their care, persistent stigmatization of PLHIV and frequent reliance on alternative healing systems instead of biomedical treatment. Positive perceptions of the efficacy of ART, improved ART availability in the region, improved access to care through supplemental aid, and social support were perceived to enhance treatment continuation. Our findings suggest that numerous socioeconomic and sociocultural barriers inhibit retention in HIV care and treatment services in this setting. Intervention strategies that improve ART accessibility, incorporate supplemental aid, enhance social support, reduce stigma, and develop partnerships with alternative healers are needed to improve HIV-related outcomes.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24279762</PMID><DateCreated><Year>2014</Year><Month>04</Month><Day>16</Day></DateCreated><DateCompleted><Year>2014</Year><Month>10</Month><Day>09</Day></DateCompleted><DateRevised><Year>2014</Year><Month>04</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1360-0451</ISSN><JournalIssue CitedMedium="Internet"><Volume>26</Volume><Issue>7</Issue><PubDate><Year>2014</Year></PubDate></JournalIssue><Title>AIDS care</Title><ISOAbbreviation>AIDS Care</ISOAbbreviation></Journal><ArticleTitle>Barriers and facilitators of retention in HIV care and treatment services in Iringa, Tanzania: the importance of socioeconomic and sociocultural factors.</ArticleTitle><Pagination><MedlinePgn>907-13</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/09540121.2013.861574</ELocationID><Abstract><AbstractText>Although an increasing number of people living with HIV (PLHIV) in sub-Saharan Africa are benefiting from the rapid scale-up of antiretroviral therapy (ART), retention in HIV care and treatment services remains a major concern. We examined socioeconomic and sociocultural barriers and potential facilitators of retention in ART in Iringa, Tanzania, a region with the second highest prevalence of HIV in the country. In 2012, 116 in-depth interviews were conducted to assess community members' perceptions, barriers and facilitators of HIV treatment in Iringa, including key informants, persons at heightened risk for infection, and HIV service-delivery users. Data were transcribed, translated, entered into Atlas.ti, coded, and analyzed for key themes. In order to provide the full range of perspectives across the community on issues that may affect retention, we report findings from all 116 participants, but draw on verbatim quotes to highlight the experiences of the 14 PLHIV who reported that they were receiving HIV care and treatment services. Despite the growing availability of HIV care and treatment services in Iringa, participants reported significant barriers to retention, including lack of knowledge and misperceptions of treatment, access problems that included difficulties in reaching distant clinics and pervasive poverty that left PLHIV unable to cope with out-of-pocket costs associated with their care, persistent stigmatization of PLHIV and frequent reliance on alternative healing systems instead of biomedical treatment. Positive perceptions of the efficacy of ART, improved ART availability in the region, improved access to care through supplemental aid, and social support were perceived to enhance treatment continuation. Our findings suggest that numerous socioeconomic and sociocultural barriers inhibit retention in HIV care and treatment services in this setting. Intervention strategies that improve ART accessibility, incorporate supplemental aid, enhance social support, reduce stigma, and develop partnerships with alternative healers are needed to improve HIV-related outcomes.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tomori</LastName><ForeName>Cecilia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>a Department of Epidemiology , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kennedy</LastName><ForeName>Caitlin E</ForeName><Initials>CE</Initials></Author><Author ValidYN="Y"><LastName>Brahmbhatt</LastName><ForeName>Heena</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>Wagman</LastName><ForeName>Jennifer A</ForeName><Initials>JA</Initials></Author><Author ValidYN="Y"><LastName>Mbwambo</LastName><ForeName>Jessie K</ForeName><Initials>JK</Initials></Author><Author ValidYN="Y"><LastName>Likindikoki</LastName><ForeName>Samuel</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Kerrigan</LastName><ForeName>Deanna L</ForeName><Initials>DL</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>11</Month><Day>27</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>AIDS Care</MedlineTA><NlmUniqueID>8915313</NlmUniqueID><ISSNLinking>0954-0121</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" 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PubStatus="pubmed"><Year>2013</Year><Month>11</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>10</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24279762</ArticleId><ArticleId IdType="doi">10.1080/09540121.2013.861574</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li></region></list><tree><noCountry><name sortKey="Brahmbhatt, Heena" sort="Brahmbhatt, Heena" uniqKey="Brahmbhatt H" first="Heena" last="Brahmbhatt">Heena Brahmbhatt</name><name sortKey="Kennedy, Caitlin E" sort="Kennedy, Caitlin E" uniqKey="Kennedy C" first="Caitlin E" last="Kennedy">Caitlin E. Kennedy</name><name sortKey="Kerrigan, Deanna L" sort="Kerrigan, Deanna L" uniqKey="Kerrigan D" first="Deanna L" last="Kerrigan">Deanna L. Kerrigan</name><name sortKey="Likindikoki, Samuel" sort="Likindikoki, Samuel" uniqKey="Likindikoki S" first="Samuel" last="Likindikoki">Samuel Likindikoki</name><name sortKey="Mbwambo, Jessie K" sort="Mbwambo, Jessie K" uniqKey="Mbwambo J" first="Jessie K" last="Mbwambo">Jessie K. Mbwambo</name><name sortKey="Wagman, Jennifer A" sort="Wagman, Jennifer A" uniqKey="Wagman J" first="Jennifer A" last="Wagman">Jennifer A. Wagman</name></noCountry><country name="États-Unis"><region name="Maryland"><name sortKey="Tomori, Cecilia" sort="Tomori, Cecilia" uniqKey="Tomori C" first="Cecilia" last="Tomori">Cecilia Tomori</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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