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Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa

Despite advances made in HIV prevention and treatment interventions in South Africa, barriers to their utilization continue to exist. Understanding perspectives from patients and providers of healthcare can shed light on the necessary strategies to enhance uptake of HIV services. A cross-sectional q...

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Autores principales: Chimoyi, Lucy, Chikovore, Jeremiah, Musenge, Eustasius, Mabuto, Tonderai, Chetty-Makkan, Candice. M., Munyai, Reuben, Nchachi, Tshegang, Charalambous, Salome, Setswe, Geoffrey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021737/
https://www.ncbi.nlm.nih.gov/pubmed/36962320
http://dx.doi.org/10.1371/journal.pgph.0000132
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author Chimoyi, Lucy
Chikovore, Jeremiah
Musenge, Eustasius
Mabuto, Tonderai
Chetty-Makkan, Candice. M.
Munyai, Reuben
Nchachi, Tshegang
Charalambous, Salome
Setswe, Geoffrey
author_facet Chimoyi, Lucy
Chikovore, Jeremiah
Musenge, Eustasius
Mabuto, Tonderai
Chetty-Makkan, Candice. M.
Munyai, Reuben
Nchachi, Tshegang
Charalambous, Salome
Setswe, Geoffrey
author_sort Chimoyi, Lucy
collection PubMed
description Despite advances made in HIV prevention and treatment interventions in South Africa, barriers to their utilization continue to exist. Understanding perspectives from patients and providers of healthcare can shed light on the necessary strategies to enhance uptake of HIV services. A cross-sectional qualitative study was conducted in July 2020 in Ekurhuleni District. Based on HIV prevalence estimates from a national survey, male condom use coverage and antiretroviral treatment (ART) initiation rates from routinely collected clinical data for 2012, we selected facilities from geographical areas with varying HIV prevalence and uptake of HIV services. In-depth interviews were conducted with adult (≥18 years) patients and healthcare workers in selected primary healthcare facilities. Thematic analysis was performed following a framework built around the social cognitive theory to describe behavioural, personal, and social/environmental factors influencing utilization of HIV services. Behavioural factors facilitating uptake of HIV services included awareness of the protective value of condoms, and the benefits of ART in suppressing viral load and preventing mother-to-child HIV transmission which was evident across geographical areas. Barriers in high prevalence areas included suboptimal condom use, fears of a positive HIV result, and anticipated HIV-related stigma while seeking healthcare services. Across the geographical areas, personal factors included ability to correctly use available services enhanced by knowledge acquired during counselling sessions and community-based health promotion activities. Further, social support from family reinforced engagement in care. Compared to low uptake areas, clinics in high uptake areas used care-facilitators, outreach teams and decanting programs to address the environmental barriers including staff shortages and long queues. Barriers at multiple levels prevent optimal utilization of HIV services, calling for strategies that target and address the different levels and tailored to needs of specific settings. Overall, improved delivery of HIV prevention or treatment interventions can be achieved through strengthening training of healthcare providers in facilities and communities and addressing negative sequelae from utilising services in low uptake areas.
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spelling pubmed-100217372023-03-17 Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa Chimoyi, Lucy Chikovore, Jeremiah Musenge, Eustasius Mabuto, Tonderai Chetty-Makkan, Candice. M. Munyai, Reuben Nchachi, Tshegang Charalambous, Salome Setswe, Geoffrey PLOS Glob Public Health Research Article Despite advances made in HIV prevention and treatment interventions in South Africa, barriers to their utilization continue to exist. Understanding perspectives from patients and providers of healthcare can shed light on the necessary strategies to enhance uptake of HIV services. A cross-sectional qualitative study was conducted in July 2020 in Ekurhuleni District. Based on HIV prevalence estimates from a national survey, male condom use coverage and antiretroviral treatment (ART) initiation rates from routinely collected clinical data for 2012, we selected facilities from geographical areas with varying HIV prevalence and uptake of HIV services. In-depth interviews were conducted with adult (≥18 years) patients and healthcare workers in selected primary healthcare facilities. Thematic analysis was performed following a framework built around the social cognitive theory to describe behavioural, personal, and social/environmental factors influencing utilization of HIV services. Behavioural factors facilitating uptake of HIV services included awareness of the protective value of condoms, and the benefits of ART in suppressing viral load and preventing mother-to-child HIV transmission which was evident across geographical areas. Barriers in high prevalence areas included suboptimal condom use, fears of a positive HIV result, and anticipated HIV-related stigma while seeking healthcare services. Across the geographical areas, personal factors included ability to correctly use available services enhanced by knowledge acquired during counselling sessions and community-based health promotion activities. Further, social support from family reinforced engagement in care. Compared to low uptake areas, clinics in high uptake areas used care-facilitators, outreach teams and decanting programs to address the environmental barriers including staff shortages and long queues. Barriers at multiple levels prevent optimal utilization of HIV services, calling for strategies that target and address the different levels and tailored to needs of specific settings. Overall, improved delivery of HIV prevention or treatment interventions can be achieved through strengthening training of healthcare providers in facilities and communities and addressing negative sequelae from utilising services in low uptake areas. Public Library of Science 2022-02-03 /pmc/articles/PMC10021737/ /pubmed/36962320 http://dx.doi.org/10.1371/journal.pgph.0000132 Text en © 2022 Chimoyi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Chimoyi, Lucy
Chikovore, Jeremiah
Musenge, Eustasius
Mabuto, Tonderai
Chetty-Makkan, Candice. M.
Munyai, Reuben
Nchachi, Tshegang
Charalambous, Salome
Setswe, Geoffrey
Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title_full Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title_fullStr Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title_full_unstemmed Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title_short Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa
title_sort understanding factors influencing utilization of hiv prevention and treatment services among patients and providers in a heterogeneous setting: a qualitative study from south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021737/
https://www.ncbi.nlm.nih.gov/pubmed/36962320
http://dx.doi.org/10.1371/journal.pgph.0000132
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