HIV-positive migrants’ encounters with the Swedish health care system

Abstract

BackgroundThere is limited knowledge about human immunodeficiency virus (HIV)-positive migrants and their experiences in the Swedish health care system. It is necessary to increase our knowledge in this field to improve the quality of care and social support for this vulnerable group of patients.ObjectiveThe aim of this study was to describe the experiences of HIV-positive migrants and their encounters with the health care system in Sweden.DesignThis is a Grounded Theory study based on qualitative interviews with 14 HIV-positive migrants living in Sweden, aged 29–55 years.Results‘A hybrid of access and adversity’ was identified as the core category of the study. Three additional categories were ‘appreciation of free access to treatment’, ‘the impact of the Swedish Disease Act on everyday life’, and ‘encountering discrimination in the general health care system’. The main finding indicated that participants experienced frustration and discrimination because they were required to provide sexual partners with information about their HIV status, which is compulsory under the Swedish Disease Act. The study also showed that the bias or fear regarding HIV infection among general health care professionals outside of the infectious diseases clinics limited the access to the general health care system for HIV-positive migrants.ConclusionsThe HIV-positive migrants appreciated the free access to antiviral therapy, but wished to have more time for patient–physician communications. The participants of this study felt discrimination in health care settings outside of the infectious diseases clinics. There is a need to reduce the discrimination in general health care services and to optimize the social support system and social network of this vulnerable group.

Migrants’ perceptions of health system responsiveness and satisfaction with health workers in a South African Province

“…The patient complaints about discrimination because of nationality are of concern, and have been found in other studies as well [21,56]. We did not ask patients explicitly whether they experienced discrimination, and this needs further research.…”

“…In Germany [ 17 , 18 ] and Denmark [ 19 ], studies found that migrant patients’ satisfaction with health care services were influenced by communication by, and cultural sensitivity of, health care providers. A 2016 qualitative study that explored HIV-positive migrants’ experiences in the Swedish health care system found that they appreciated access to free antiretroviral therapy, but felt discrimination in health care settings outside of the infectious diseases clinics [ 21 ].…”

Knowledge about HIV/AIDS in older adults using the services of Family Health Strategy

“…It also stands out that health professionals do not address this subject during consultations with elders 5,13 . Some authors have pointed out that HIV information is scarce and there is a critical need to work towards increasing it, especially to help diminish prejudice and promote the internalization of preventive behaviors in the population 14 .…”

Navigating between rules and reality: a qualitative study of HIV positive MSM’s experiences of communication at HIV clinics in Sweden about the rules of conduct and infectiousness

“…Previous studies in Sweden have shown that the Swedish Communicable Diseases Control Act is perceived as both supportive, as it ensures access to free treatment, and as a burden, e.g., in regards to disclosure obligation (Christiansen, Lalos, & Johansson, 2008;Mehdiyar, Andersson, Hjelm, & Povlsen, 2016). To our knowledge, no previous studies have explored this topic since the possibility of being exempted from the obligation to disclose HIV status.…”