Why some MSM present late for HIV testing: a qualitative analysis

Dowson, Lucy; Kober, Catherine; Perry, Nicky; Fisher, Martin; Richardson, Daniel

doi:10.1080/09540121.2011.597711

Cited by 72 publications

(55 citation statements)

References 12 publications

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“…The relationship between doctors and patients is often marred by mistrust and poor communication [30]. Doctors are offended when patients ask questions or seek a second opinion [31–33], and do not sufficiently encourage clients to be tested for HIV after their initial decline [7]. Rather, they keep patients uninformed about a provisional diagnosis, particularly in the case of stigmatized diseases.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…So far, several barriers impairing HIV testing have been identified, both among patients and health care providers [31][32][33]. Among the most important of these barriers in Poland are perception of low or no risk, fear of disclosure among patients (HIV stigma), and lack of knowledge and self-confidence among health care providers when proposing HIV testing.…”

Section: Discussionmentioning

confidence: 99%

Late presenters among newly diagnosed HIV-infected in Poland in 2006-2008

Pyziak-Kowalska¹,

Dusza²,

Mularska³

et al. 2017

HIV & AIDS Review

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“…Epidemiological evidence for early detection and treatment is promising, and routine testing enables early diagnosis and treatment of infection and may reduce disease transmission 8,20,31,32 . Added to these advantages, knowledge of HIV serostatus reduces risky behavior and thereby reduces transmission of the virus 25,33 .…”

Section: Discussionmentioning

confidence: 99%

“…Personal self-negotiation concerning risk and testing may also be manifest in the finding that respondents recommend regular and routine testing for others, even if they themselves do not test. These elements might be integrated into future campaigns to encourage early and routine testing 25 .…”

Section: Discussionmentioning

confidence: 99%