A Social-Ecological Framework to Understand Barriers to HIV Clinic Attendance in Nakivale Refugee Settlement in Uganda

A Qualitative Study

Dados Bibliográficos

ID15337887
AutoresKelli N O’laughlin (0000-0003-3027-1883, University of Washington, autor correspondente), Kelsy E Greenwald (0000-0002-6380-6824, Harvard Affiliated Emergency Medicine Residency), Sarah K Rahman (Wesleyan University), Zikama M Faustin (Bugema University), Scholastic Ashaba (0000-0002-5822-2488, Mbarara University of Science and Technology), Alexander C Tsai (0000-0001-6397-7917, Harvard University), N C Ware (0000-0002-5039-9991, Brigham and Women's Hospital), Andrew Kambugu (0000-0002-3075-0211, Infectious Diseases Institute), Ingrid V Bassett (0000-0001-6920-6080, Harvard University)
Ano2020
Volume25
Fascículo6
Páginas1729-1736
Data de publicação2020-12-02
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoAIDS and Behavior (JOURNAL)
Identificadores do periódicoISSN: 1090-7165 • E-ISSN: 1573-3254
EditoraSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s10461-020-03102-x
PMID33263892
OpenAlexW3108362300
IdiomaEN
Citações recebidas10
Referências citadas47

The social-ecological model proposes that efforts to modify health behaviors are influenced by constraints and facilitators at multiple levels. We conducted semi-structured interviews with 47 clients in HIV care and 8 HIV clinic staff to explore how such constraints and facilitators (individual, social environment, physical environment, and policies) affect engaging in HIV clinical care in Nakivale Refugee Settlement in Uganda. Thematic analysis revealed that participants were motivated to attend the HIV clinic because of the perceived quality of services and the belief that antiretroviral therapy improves health. Barriers to clinic attendance included distance, cost, unemployment, and climate. Those that disclosed their status had help in overcoming barriers to HIV care. Nondisclosure and stigma disrupted community support in overcoming these obstacles. Interventions to facilitate safe disclosure, mobilize social support, and provide more flexible HIV services may help overcome barriers to HIV care in this setting

Attendance · Environmental health · Family medicine · Health care · Health psychology · Human immunodeficiency virus (HIV · Political science · Psychiatry · Psychological intervention · Public health · Qualitative research · Social stigma · Social support · Sociology · Stigma (botany · Thematic analysis · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Psychology · Social Psychology