Understanding HIV-infected patients’ experiences with Pepfar-associated transitions at a Centre of Excellence in KwaZulu Natal, South Africa

A qualitative study

Bibliographic Data

ID19443185
AuthorsIngrid T Katz (0000-0002-3014-238X, Brigham and Women's Hospital), Laura M Bogart (0000-0003-3182-5542, Boston Children's Hospital), Christie Cloete (McCord Hospital), Tamaryn L Crankshaw (0000-0001-6974-1593, University of KwaZulu-Natal), Janet Giddy (0000-0002-1316-8078, McCord Hospital), Tessa Govender (McCord Hospital), Melanie R Gaynes (Massachusetts General Hospital), Dominick Leone (0000-0002-6401-2292, Boston University), Elena Losina (0000-0002-3424-0892, Boston University), Ingrid V Bassett (0000-0001-6920-6080, Brigham and Women's Hospital, corresponding author)
Year2015
Volume27
Issue10
Pages1298-1303
Publication date2015-10-03
Open AccessNo
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2015.1051502
PMID26300297
PMCIDPMC4548805
OpenAlexW2114558751
LanguageEN
Citations received4
References cited19

South Africa was the largest recipient of funding from the President's Emergency Plan for AIDS Relief (PEPFAR) for antiretroviral therapy (ART) programs from 2004 to 2012. Funding decreases have led to transfers from hospital and non-governmental organization-based care to government-funded, community-based clinics. We conducted semi-structured interviews with 36 participants to assess patient experiences related to transfer of care from a PEPFAR-funded, hospital-based clinic in Durban to either primary care clinics or hospital-based clinics. Participant narratives revealed the importance of connectedness between patients and the PEPFAR-funded clinic program staff, who were described as respectful and conscientious. Participants reported that transfer clinics were largely focused on dispensing medication and on throughput, rather than holistic care. Although participants appreciated the free treatment at transfer sites, they expressed frustration with long waiting times and low perceived quality of patient-provider communication, and felt that they were treated disrespectfully. These factors eroded confidence in the quality of the care. The transfer was described by participants as hurried with an apparent lack of preparation at transfer clinics for new patient influx. Formal (e.g., counseling) and informal (e.g., family) social supports, both within and beyond the PEPFAR-funded clinic, provided a buffer to challenges faced during and after the transition in care. These data support the importance of social support, adequate preparation for transfer, and improving the quality of care in receiving clinics, in order to optimize retention in care and long-term adherence to treatment

Excellence · Family medicine · Political science · Qualitative research · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Nursing

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