HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran

Asadi, Heshmatollah; Imani-Nasab, Mohammad Hasan; Garavand, Ali; Hasoumi, Mojtaba; Kia, Abdollah Almasian; Haghi, Behzad; Setoodehzadeh, Fatemeh

doi:10.2174/1874613601812010150

Cited by 9 publications

(6 citation statements)

References 15 publications

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“…Participants stated financial concerns about costs of transportation, drugs for opportunistic infections, additional costs including food and accommodation as well as missed work when seeking care. This is comparable with a study conducted in Iran [ 24 ] and Zimbabwe [ 23 ]. Another study in Kenya [ 22 ] also showed that older adults described the challenges they face with costs of transportation when accessing the facilities to seek HIV care services from a distant clinic.…”

Section: Discussionsupporting

confidence: 90%

Patient experiences and preferences for antiretroviral therapy service provision: implications for differentiated service delivery in Northwest Ethiopia

et al. 2022

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Background Understanding the experiences, needs, preferences, and behaviors of people living with HIV (PLHIV) are critical to tailor HIV treatment. However, there is limited empirical evidence in Ethiopia on the views of PLHIV regarding their experiences with current antiretroviral therapy (ART) services and preferred models of HIV treatment. Hence, this study aimed to explore the patients’ experiences of taking medications and preferences for ART service provision in Northwest Ethiopia. Methods A phenomenological study design was employed. In this study, stable and 18 years old and above PLHIVs, who had been using ART service at four public hospitals and two health centers in East Gojjam, West Gojjam and Awi zones, and Bahir Dar city administration of Amhara National Regional State, Northwest Ethiopia, were purposively selected. Fifteen in-depth interviews were conducted from July 2021 to September 2021 to collect data. ATLAS.ti version 9 software was used for coding translated transcripts. A thematic analysis approach was employed. Findings Participants in this study had reported positive and negative experiences in receiving ART services and also varied preferences toward ART service features. The study identified five themes on experiences for ART service and 15 attributes of ART service characteristics. The identified themes were stigma, time, availability of drugs and providers, costs for clinic visits, and provider-patient interaction. The fifteen attributes were buddy system, ART refill (individualized or group), ART packaging and labeling, drug formulation and administration, ART room labeling, distance, location of service, preferences on involvement in treatment decision-making, the person providing ART refills, provider’s attitude, spatial arrangement of ART room, time of health facility operation, time spent at clinics, and total cost of the visit. Conclusions The results raise awareness for the positive and negative experiences of patients informing us about barriers and supporting factors in ART service provision. They open up the potential for HIV treatment service improvement. The preferences of PLHIVs toward ART service delivery features were heterogeneous. Policy and program efforts should tailor ART services that suit patients’ needs and priorities in Ethiopia. Future research should further assess the reasons for patients’ distrust of the community ART delivery models.

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Section: Discussionsupporting

confidence: 90%

Patient experiences and preferences for antiretroviral therapy service provision: implications for differentiated service delivery in Northwest Ethiopia

et al. 2022

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“…Participants stated nancial concerns about costs of transportation, drugs for opportunistic infections, additional costs including food and accommodation as well as missed work when seeking care. This is comparable with a study conducted in Iran [22]. This highlights that further decentralization of ART services to lower-level health facilities and availing a free or subsidized cost for treatment of opportunistic infections are needed which in turn contributes towards the achievement of the goal of universal health coverage by 2030.…”

Section: Participant Experiences With Antiretroviral Therapy Servicesupporting

confidence: 83%

Patient experiences and preferences for antiretroviral therapy service provision characteristics: implications for implementing differentiated service delivery in Northwest Ethiopia

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Yitayal

Atnafu

et al. 2022

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BackgroundUnderstanding the experiences, needs, preferences, and behaviors of people living with HIV (PLHIV) are critical to tailor HIV treatment. However, there is limited research evidence in Ethiopia on the views of PLHIV regarding their positive and negative experiences on current antiretroviral therapy (ART) service and their preferred models of HIV treatment. Hence, this study aimed to explore patients’ experiences of taking medications and preferences for ART service provision characteristics in Northwest Ethiopia.MethodsThis study with a phenomenological approach was conducted as part of the larger discrete choice experiment study. Purposive selection of stable and 18 years old and above PLHIVs using ART service at health facilities implementing four differentiated service delivery (DSD) models in East Gojjam, West Gojjam, Awi, and Bahir Dar special zones was done. Data were collected between July and September 2021. About 15 in-depth interviews with differentiated ART eligible patients were conducted. ATLAS.ti version 9 software was used for coding translated transcripts. A thematic analysis approach was employed.FindingsParticipants in this study had reported both positive and negative experiences in receiving ART. Five themes: stigma, time, availability of drug and provider, costs per clinic visit, provider-patient interaction were identified. Participants also reported varied preferences towards ART service features. Fifteen attributes: buddy system, ART refill (individualized or group), ART packaging and labeling, drug formulation and administration, ART room labeling, distance, location of service, preferences on involvement in treatment decision-making, person providing ART refills, provider’s attitude, spatial arrangement of ART room, time of health facility operation, time spent at clinics and total cost of visit were identified.ConclusionsParticipants provided both positive and negative experiences with the aspects of current ART service. The preferences of PLHIVs towards ART service delivery features were heterogeneous. Policy and program efforts should tailor ART services that suit patients’ needs and priorities in Ethiopia. Future research should also focus on understanding the satisfaction of patients enrolled among the four DSD models now under implementation in the country to get insights for optimizing each model implementation and to ensuring the strong quality of ART service provision for stable PLHIV.

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“…It was possible for PLWHA to experience disrupted relationships with families and communities, isolation, criticism, and ostracism by family members, abuse, violence, divorce, or separation from partners, rejection by friends, stigma and discrimination by healthcare workers and public, losing their jobs, and being out as PLWHA after HIV disclosure. [8,9,12,14,16–18] Nevertheless, negative reactions were relatively low, and 76.1% of PLWHA declared that they did not regret to disclose their HIV serostatus. [9,19]…”

Section: Introductionmentioning

confidence: 99%

Status and associated characteristics of HIV disclosure among people living with HIV/AIDS in Liangshan, China

et al. 2019

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Human immunodeficiency virus (HIV) disclosure is a prerequisite to get access to antiretroviral therapy (ART) and social support. Increased disclosure of HIV status has been shown to reduce mother-to-child transmission and high-risk sexual behaviors. Limited studies were conducted to get an insight into HIV disclosure among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA) in Liangshan. Our study aimed to investigate the status and associated characteristics of HIV disclosure among PLWHA in Liangshan. We conducted a cross-sectional study using a stratified, convenience sampling method from August to December in 2017. All of the participants were from Liangshan, a typical impoverished mountainous area which also has a long history of drug production and drug trade. Each participant completed a structured questionnaire including HIV disclosure status, demographic and HIV-related characteristics, social support, and perceived HIV-related stigma. We performed a binary regression analysis to detect associated characteristics of HIV disclosure among PLWHA in Liangshan. A final sample size of 318 participants was included in this study. The overall prevalence of HIV disclosure was 83.6% (266/318). In binary logistic regression analysis, PLWHA who had higher educational levels, and got infected by sexual transmission were less likely to disclose their HIV status (both P < .05). HIV nondisclosure was correlated with a higher level of perceived HIV-related stigma ( P < .01). The prevalence of HIV disclosure was relatively low in Liangshan. Healthcare workers are suggested to conduct more counseling and education to promote safe sexual behaviors and reduce perceived stigma among PLWHA, then enhance HIV serostatus disclosure.

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HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran

Cited by 9 publications

References 15 publications

Patient experiences and preferences for antiretroviral therapy service provision: implications for differentiated service delivery in Northwest Ethiopia

Patient experiences and preferences for antiretroviral therapy service provision: implications for differentiated service delivery in Northwest Ethiopia

Patient experiences and preferences for antiretroviral therapy service provision characteristics: implications for implementing differentiated service delivery in Northwest Ethiopia

Status and associated characteristics of HIV disclosure among people living with HIV/AIDS in Liangshan, China

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