Negative clinic experiences as a barrier to care for people with HIV and their impact on patient preferences for intervention support
A qualitative study in Cape Town, South Africa
Bibliographic Data
| ID | 19441248 |
|---|---|
| Authors | Clare Killian (Boston University, corresponding author), Rebecca West (0000-0002-2958-0884, Boston University), Rebecca L West, Catherine Orrell (0000-0003-1134-7475, Desmond Tutu HIV Foundation), Allen L Gifford (0000-0001-6442-1128, Boston University), Allen Gifford, Jessica E Haberer (0000-0001-5845-3190, Harvard University), Nafisa Halim (0000-0002-6529-4455, Boston University), Lauren Jennings (0000-0003-4749-2404, Desmond Tutu HIV Foundation), Natacha Berkowitz (0000-0002-8797-5593, City of Cape Town), Stephanie Fourie (Western Cape Department of Health), Lora Sabin (0000-0002-2782-542X, Boston University) |
| Year | 2024 |
| Volume | 36 |
| Issue | 9 |
| Pages | 1222-1231 |
| Publication date | 2024-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | AIDS Care (JOURNAL) |
| Journal identifiers | ISSN: 0954-0121 • E-ISSN: 1360-0451 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09540121.2024.2346255 |
| PMID | 38676915 |
| OpenAlex | W4395690217 |
| Language | EN |
| References cited | 27 |
We conducted qualitative research among people with HIV (PWH) and care providers in Cape Town, South Africa to understand the impact of negative clinic experiences on adherence and support preferences. In-depth interviews were conducted with 41 patients with an unsuppressed viral load or a treatment gap, and focus group discussions with physicians, nurses, counselors, and community health workers. Questions addressed treatment history and adherence barriers, then participants evaluated evidence-based adherence interventions for potential scale up. Inductive analysis examined care experiences and corresponding preference for intervention options. More than half of PWH described negative experiences during clinic visits, including mistreatment by staff and clinic administration issues, and these statements were corroborated by providers. Those with negative experiences in care stated that fear of mistreatment led to nonadherence. Most patients with negative experiences preferred peer support groups or check-in texts to clinic-based interventions. We found that PWH's negative clinic experiences were a primary reason behind nonadherence and influenced preferences for support mechanisms. These findings emphasize the importance of HIV treatment adherence interventions at multiple levels both in and outside of the clinic, and providing more comprehensive training to providers to better serve PWH in adherence counseling, especially those who are most vulnerable
Family medicine · Focus group · Peer support · Psychological intervention · Qualitative research · Adolescent Sexual and Reproductive Health · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing
Challenges of quality improvement in the healthcare of South Africa post-apartheid
Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa
Consolidated criteria for reporting qualitative research (Coreq)
Barriers to care among people living with HIV in South Africa
Stumbling Blocks at the Clinic
The Acceptability and Perceived Usefulness of a Weekly Clinical SMS Program to Promote HIV Antiretroviral Medication Adherence in KwaZulu-Natal, South Africa
Patients’ and Providers’ Views on Optimal Evidence-Based and Scalable Interventions for Individuals at High Risk of HIV Treatment Failure
Health Care Providers' Challenges to High-Quality HIV Care and Antiretroviral Treatment Retention in Rural South Africa
Comparing Patients' Experiences in Three Differentiated Service Delivery Models for HIV Treatment in South Africa
Patients Are Not Following the [Adherence] Club Rules Anymore
| Citation velocity | historical |
|---|---|
| Highly cited | No |