title: 'I'm fed up': experiences of prior anti-tuberculosis treatment in patients with drug-resistant tuberculosis and HIV.
abstract: OBJECTIVE
  To understand the impact of past experiences of anti-tuberculosis treatment among patients co-infected with the human immunodeficiency virus and multidrug-resistant tuberculosis (MDR-TB) on perceptions and attitudes towards treatment.
  
  
  METHODS
  Qualitative study using in-depth interviews with 12 HIV-MDR-TB co-infected patients in Mumbai, India.
  
  
  RESULTS
  Patients reported unnecessarily long pathways to care and fatigue with diagnostic and treatment procedures. In particular, they expressed concerns over the lack of efficacy of their current treatment regimen based on their experiences with anti-tuberculosis treatment regimens in the past.
  
  
  CONCLUSIONS
  Patients reported negative experiences with previous HIV and anti-tuberculosis treatment. Access to early diagnosis and rapid initiation of integrated care for HIV-MDR-TB co-infected patients, with a strong, patient-centered support system, could help to combat the low morale and lack of faith in treatment described in this group of patients.
authors.affiliation: Tuberculosis Research Unit, Case Western Reserve University, Cleveland, Ohio, USA;
authors.forename: J
authors.initials: J
authors.lastname: Furin
authors.affiliation: Médecins Sans Frontières (MSF), Mumbai, India.
authors.forename: P
authors.initials: P
authors.lastname: Isaakidis
authors.affiliation: MSF, Operational Research Unit, Luxembourg.
authors.forename: A J
authors.initials: AJ
authors.lastname: Reid
authors.affiliation: Institute of International Health & Development, Queen Margaret University, Edinburgh, Scotland, UK.
authors.forename: K
authors.initials: K
authors.lastname: Kielmann
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D060085:Coinfection; D017281:Cost of Illness; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010465:Perception; D011237:Predictive Value of Tests; D036301:Qualitative Research; D011788:Quality of Life; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D014850:Waiting Lists
chemical_list: D000995:Antitubercular Agents