HIV understanding, experiences and perceptions of HIV-positive men who have sex with men in Amazonian Peru: a qualitative study

Abstract

Background: HIV-related incidence and mortality is increasing across Peru, with highest mortality rates recorded in the Amazonian region of Loreto. This epidemic is concentrated in men who have sex with men, a population with 14% HIV treatment adherence despite free national provision. This study investigates barriers and facilitators to following healthcare advice through experiences and perceptions of HIV-positive men who have sex with men and healthcare professionals in Loreto. Methods: Twenty qualitative interviews with HIV-positive men who have sex with men and one focus group with HIV-specialist healthcare professionals were conducted in Loreto, January-February 2019. Interviews were transcribed per verbatim. Thematic content analysis and deviant case analysis were used. Results: A culture of isolation and discrimination was identified, propagated by poor public knowledge surrounding HIV transmission and treatment. Employment potential was hampered and 7/20 patients had suicidal thoughts post-diagnosis. Barriers to care included: shame, depression, travel cost/times, a preference for traditional plant-based medicine and side-effects of antiretroviral therapy. Facilitators included: education, family and clinic support, disease acceptance and lifestyle changes. Conclusion: More effective, focussed community education and workplace discrimination investigations are recommended to reduce stigma and increase adherence to treatment in this population.

Clinical and Metagenomic Characterization of Neurological Infections of People With Human Immunodeficiency Virus in the Peruvian Amazon

“…Forty percent of study participants were diagnosed with HIV within the 3 months prior to enrollment with low CD4 counts (median CD4 count of 119 cells/mm 3 ), which likely was a key factor in the high mortality. Previous work in Loreto has shown high rates of discrimination against PWH and misconceptions about HIV, creating barriers to testing, care, and treatment adherence [ 25 ]. Though 52% of participants were on ARVs, a third of those forgot to take their medication ≥3 times per week.…”

Determinants of the Discriminatory Behavior Experienced by People Living with HIV in Indonesia: A Cross-sectional Study of the Demographic Health Survey

“…People who have more knowledge about HIV/AIDS will fear and discriminate against PLHIV [34 -36]. Thus, many people have negative views about PLHIV [37] because people believe that PLHIV can transmit HIV/AIDS to others [35,38]. People do not accept the risk, so they prefer to stay away from rather than live with PLHIV [38].…”

“…Thus, many people have negative views about PLHIV [37] because people believe that PLHIV can transmit HIV/AIDS to others [35,38]. People do not accept the risk, so they prefer to stay away from rather than live with PLHIV [38]. Therefore, it is necessary to build accurate knowledge to reduce the stigma associated with PLHIV.…”