title: [Health care organisation and chronic disease. A mobility-based approach].
abstract: HIV/AIDS has been considered to be a chronic disease since highly active antiretroviral therapies became available at the end of the 1990s. As a result, people living with HIV now need to adjust their lives to a situation of medical dependence. Accessing and transitioning between health care services, and coordinating multiple recourses between services as well as the patient's own activities, often require an invisible but considerable amount of work for the patient. This work consists of anticipating deterioration of their state of health, developing techniques to harmonize their use of health care services and their changing expectations about health care services. A doctoral thesis in sociology on "urban health pathways" of HIV-positive people studied the social and spatial mobility aspects of this work. Illness experiences were collected in Brussels (Belgium) and Rouen (France) and analysed by the typological method. Identification of "modes of action" highlights this work of HIV-infected people during two phases of their life with the virus: firstly, acceptance of the needfor health care and social services and, secondly, adaptation to an effectively or potentially worsening health condition. Such modes of action reveal different definitions of the quality of health-care from the patient's point of view and the way patients move through the health care supply to achieve this quality. Interview-based data collection encountered the same difficulties as other previous qualitative studies on HIV Focusing on the mobility of chronic patients can provide useful findings for the organization of health care services.
authors.forename: Maguelone
authors.initials: M
authors.lastname: Vignes
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000628:therapy; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D001530:Belgium / Q000453:epidemiology; D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration*; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D011788:Quality of Life; D020377:Self Efficacy; D012937:Social Mobility