Challenges with access to healthcare from the perspective of patients living with HIV: a scoping review & framework synthesis

Abstract

Accessing healthcare can be difficult but the barriers multiply for people living with HIV (PLHIV). To improve access and the health of PLHIV, we must consider their perspectives and use them to inform standard practice. A better understanding of the current literature related to healthcare access from the perspective of PLHIV, can help to identify evidence gaps and highlight research priorities and opportunities. To identify relevant peer-reviewed publications, search strategies were employed. Electronic and grey literature databases were explored. Articles were screened based on their title and abstract and those that met the screening criteria, were reviewed in full. Data analysis was conducted using a collaborative approach that included knowledge user consultation. Initial concepts were extracted, summarized and through framework synthesis, developed into emerging and final themes. From 20,678 articles, 326 articles met the initial screening criteria and 64 were reviewed in full. The final themes identified, in order of most to least frequent were: Acceptability, Availability, Accessibility, Affordability, Other Barriers, Communication, Satisfaction, Accommodation, Preferences and Equity in Access. The most frequently discussed concepts related to negative interactions with staff, followed by long wait times, limited household resources or inability to pay fees, and fear of one's serostatus being disclosed. Knowledge users were in agreement with the categorization of initial concepts and final themes; however, some gaps in the literature were identified. Specific changes are critical to improving access to healthcare for PLHIV. These include improving availability by ensuring staff and healthcare professionals have proper training, cultivating acceptability and reducing stigma through improving HIV awareness, increasing accessibility through increased HIV information for PLHIV and improved dissemination of this information to increase patient knowledge and health awareness. Finally, ensuring proper protocols are implemented and followed to guarantee patient confidentiality and overall satisfaction with healthcare services are recommended.

Evidence on access to health care information by women of reproductive age in Low-and-Middle-Income Countries: Scoping Review

“…This could be due to the challenges or barriers that hinder the access to maternal healthcare services in low research settings. Similar to this Ashgari et al, (2018) in urban slums of Lagos, Nigeria has found that a total of 80.3% of the respondents had an estimated travel distance ranging from 6 to 10 km to reach a health care facility [30]. Contrary to this study some other barriers revealed by a study initiatives such as transport vouchers and maternal healthcare services vouchers are effective and may not require significant amount of resources.…”

“…Similar to our findings a study done in Nigeria by Aregbeshola et al, (2017) has found that about 10-20% of the monthly household income was spent on healthcare by 46.8% of respondents. It further found that a total of 97.9% of respondents had no health insurance coverage [30]. Another study also conducted in Nigeria by Okoronkwo et al, (2015) found that cost of medical treatment and not having insurance coverage was a major financial barrier to utilization and treatment services [64].…”

Understanding Women's Willingness to Use e-Health for HIV-Related Services: A Novel Application of the Technology Readiness and Acceptance Model to a Highly Stigmatized Medical Condition

“…T he stigmatization of health conditions is far reaching, including a variety of physical and mental health conditions. [1][2][3][4][5] Such stigmatization often results in decreased uptake of healthcare and social-behavioral services related to the stigmatized health condition. 6,7 Some researchers have suggested that delivering healthcare interventions via e-health modalities may reduce stigma.…”

Reporting and synthesis practices in barriers and facilitators reviews: a methodological systematic review

“…We humbly hope that this paper can help to facilitate improved practice in barriers and facilitators reviews. [31,33,34,[37][38][39][40][41][42][43] "If a barrier of facilitator is frequently reported, the likelihood of i being true is greater, which is why we also report those reported three or more studies." [38] "[T]he frequency that each theme is cited may not reflect their importance to people living with HIV; however, the knowledge-us team involved in the study, including people with lived experienc endorsed their importance in accessing healthcare."…”

“…[38] "[T]he frequency that each theme is cited may not reflect their importance to people living with HIV; however, the knowledge-us team involved in the study, including people with lived experienc endorsed their importance in accessing healthcare." [39] Issues regarding factor identification (e.g. publication bias and context of study) [34,39,[44][45][46][47][48][49][50] "[T]he results of the studies included in our review are already lik to be condensed.…”