Barriers to care among people living with HIV in South Africa: contrasts between patient and healthcare provider perspectives.
We collected qualitative data (semi-structured interviews with 11 healthcare providers and 10 patients; 8 focus groups with 41 patients) to identify barriers to linkage to care among people living with HIV in South Africa who were not yet taking antiretroviral treatment. Patients and providers identified HIV stigma as a sizable barrier. Patients felt that stigma-related issues were largely beyond their control, fearing discrimination if they disclosed to employers or were seen visiting clinics in their community. Providers believed that patients should take responsibility for overcoming internal stigma and disclosing serostatus. Patients had considerable concerns about inconvenient clinic hours, long queues, difficulty in appointment scheduling, and disrespect from staff. Providers seemed to minimize the effects of such barriers and not recognize the extent of patient dissatisfaction. Better communication and understanding between patients and providers are needed to facilitate greater patient satisfaction and retention in HIV care.
Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA, USA. laura.bogart@childrens.harvard.edu
Laura M
LM
Bogart
Senica
S
Chetty
Janet
J
Giddy
Alexis
A
Sypek
Laurel
L
Sticklor
Rochelle P
RP
Walensky
Elena
E
Losina
Jeffrey N
JN
Katz
Ingrid V
IV
Bassett
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy / Q000628:therapy*; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011287:Prejudice; D013019:South Africa; D013240:Stereotyping
D019380:Anti-HIV Agents