HIV testing and disclosure: a qualitative analysis of TB patients in South Africa

Daftary, Amrita; Padayatchi, Nesri; Padilla, Mark

doi:10.1080/09540120701203931

Cited by 67 publications

(86 citation statements)

References 20 publications

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“…Overall WHO estimation for HIV prevalence in new diagnosed TB patients worldwide is 8% (8). Regardless of IDU cases, HIV prevalence rate in the current study was similar to other studies reported by Zhou et (17)(18)(19)(20)(21). Reported HIV prevalence rate (17-21) ranges from 2.27% (Iran) and 2.3% (China) to 44% (Tanzania) and 60% (South Africa).…”

Section: Discussionsupporting

confidence: 91%

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Seroprevalence of HIV in Newly Detected Pulmonary Tuberculosis Patients in Khuzestan, Iran: Should HIV Testing Be Included in National Tuberculosis Program in This Region?

Alavi¹,

Moradzadegan²,

Khoshkhoy³

2013

Jundishapur J Microbiol

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Background: Human immunodeficiency virus (HIV) testing strategy for tuberculosis (TB) patients in some high HIV incidence countries has been recommended based on interaction between HIV and TB. Objectives: The present study aimed to determine the prevalence of HIV infection among newly detected pulmonary TB patients. Patients and Methods:In a cross sectional study, 104 cases including 95 non injecting drug users (IDU) and nine IDU, from 2009 to 2011 in Ahvaz capital of Khuzestan province in the south west of Iran, underwent HIV testing as early as being diagnosed as pulmonary TB. Inclusion criteria for HIV positivity was two EIA-HIV positive tests and confirmatory western blots. SPSS-16 software was employed to analyze data, including demographical characteristics, epidemiological and laboratory findings. Results: Overall HIV prevalence among pulmonary TB patients was 7.6%. Comparing HIV prevalence between non IDU pulmonary TB and IDU pulmonary TB showed that IDU cases were significantly at the risk of HIV infection [2.1% vs. 66.6%,odds ratio (95%CI): 1.6,0.31-12.97, P < 0.0001]. Conclusions: In the region under study HIV prevalence in newly detected pulmonary TB patients (except in IDU patients) was low compared with HIV high prevalence region. Therefore, routine HIV testing may not be required.

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Section: Discussionsupporting

confidence: 91%

“…population based or hospital based study) and behaviors of the subjects under study(e.g. IDUs or unsafe sex contacts) (17)(18)(19)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of HIV in Newly Detected Pulmonary Tuberculosis Patients in Khuzestan, Iran: Should HIV Testing Be Included in National Tuberculosis Program in This Region?

Alavi¹,

Moradzadegan²,

Khoshkhoy³

2013

Jundishapur J Microbiol

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“…These results confirm earlier studies showing that sociocultural determinants such as gender (being female), the status of married woman and occupation reported as housewife have been associated with diagnostic delays [22,23]. Husbands may become upset when their wives are asked to undergo testing for HIV, since it is associated with immoral behavior [24]. Similarly to our study findings, other studies have reported that female patients tend to receive less support from their families and often face financial, physical and social barriers in accessing health services [25,26].…”

Section: Discussionsupporting

confidence: 88%

How patients navigate the diagnostic ecosystem in a fragmented health system: a qualitative study from India

Yellapa

Devadasan

Krumeich

et al. 2017

Global Health Action

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Background: Depending on a country’s diagnostic infrastructure, patients and providers play different roles in ensuring that correct and timely diagnosis is made. However, little is known about the work done by patients in accessing diagnostic services and completing the ‘test and treat’ loop. Objective: To address this knowledge gap, we traced the diagnostic journeys of patients with tuberculosis, diabetes, hypertension and typhoid, and examined the work they had to do to arrive at a diagnosis. Methods: This paper draws on a qualitative study, which included 78 semi-structured interviews and 13 focus group discussions with patients, public and private healthcare providers, community health workers, test manufacturers, laboratory technicians, program managers and policymakers. Data were collected between January and June 2013 in rural and urban Karnataka, South India, as part of a larger project on barriers to point-of-care testing. We reconstructed patient diagnostic processes retrospectively and analyzed emerging themes and patterns. Results: The journey to access diagnostic services requires a high level of involvement and immense work from patients and/or their caretakers. This process entails overcoming cost and distance, negotiating social relations, continuously making sense of their illness and diagnosis, producing and transporting samples, dealing with the social consequences of diagnosis, and returning results to the treating provider. The quality and content of interactions with providers were crucial for completion of test and treat loops. If the tasks became overwhelming, patients opted out, delayed being tested, switched providers and/or reverted to self-testing or self-treatment practices. Conclusion: Our study demonstrated how difficult it can be for patients to complete diagnostic journeys and how the health system works as far as diagnostics are concerned. If new point-of-care tests are to be implemented successfully, policymakers, program officers and test developers need to find ways to ease patient navigation through diagnostic services.

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“…Socio-economic challenges may also decrease the likelihood of HIV testing, due to lack of financial resources that would enable individuals to have access to health care services. [18][19][20][21] The effect of HIV/AIDS factors (e.g., stigma and discrimination, risk perception of HIV infection, risky behaviour, HIV awareness, or knowing someone who died of HIV/AIDS) on HIV testing may depend on an individual's predisposing factors such as age, education, marital status, social and economic status. 5,22 These interactions may lead to an increased risk perception of HIV infection which may in turn decrease the willingness to utilise health care services that are linked to HIV.…”

Section: Introductionmentioning

confidence: 99%

“…12,19,29 All of these may lead to an increased risk perception of HIV infection, leading to lower or higher uptake of HIV testing. In line with the effects of risk perception on healthcare utilisation, studies have shown that perceived susceptibility as a result of risky sexual behaviour exacerbates risk perception of HIV infection, in turn leading to underutilisation of health care services.…”

Section: Introductionmentioning

confidence: 99%

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Gazimbi

Magadi²

2017

HIV/AIDS Res Treat Open J

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Introduction: Zimbabwe is still burdened with HIV epidemic and the government has an ambitious aim in the post-2015 era to end the AIDS epidemic by 2030. To achieve this, the government has set up the 90-90-90 strategic milestones to be achieved by 2020. It is a daunting task to increase HIV testing uptake from the current estimate of 56% to 90% to meet these targets. The current government's initiative requires an understanding of determinants of HIV testing. Objectives: The specific objectives of this study are to: (i) identify the individual and communitylevel determinants of HIV testing, focussing on predisposing, enabling and perceived need factors (PREP); and (ii) establish gender differences. Most PREP factors associated with HIV testing are largely consistent with patterns in Southern Africa (e.g., higher uptake by women and those who are wealthier), but unique patterns have also emerged. In particular, results reveal important gender differences: rural residence is associated with lower uptake of HIV testing for women (OR=0.74) but higher for men (OR=1.16); community wealth is a more important factor in enabling HIV testing than household wealth for women, but the converse is true for men; and individual-level, rather than community-level stigma is important for women, while for men, it is community-level stigma that is important. Conclusion: Observed gender disparities in determinants of HIV testing calls for gender specific response. Couple-oriented HIV counselling and testing services where men accompany their spouse to HIV screening during pregnancy may help increase HIV testing uptake for males and reduce gender disparities.

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HIV testing and disclosure: a qualitative analysis of TB patients in South Africa

Cited by 67 publications

References 20 publications

Seroprevalence of HIV in Newly Detected Pulmonary Tuberculosis Patients in Khuzestan, Iran: Should HIV Testing Be Included in National Tuberculosis Program in This Region?

Seroprevalence of HIV in Newly Detected Pulmonary Tuberculosis Patients in Khuzestan, Iran: Should HIV Testing Be Included in National Tuberculosis Program in This Region?

How patients navigate the diagnostic ecosystem in a fragmented health system: a qualitative study from India

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

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