Barriers to access to antiretroviral treatment for HIV-positive tuberculosis patients in Windhoek, Namibia

Seeling, Stefanie; Mavhunga, Farai; Thomas, Albertina; Adelberger, Bettina; Ulrichs, Timo

doi:10.1016/j.ijmyco.2014.07.009

Cited by 14 publications

(14 citation statements)

References 16 publications

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“…Among the first most important barriers the participants in this study reported were delays associated with receiving care from treatment centres (10.9%), long distance to treatment centres (1.1%), high financial costs associated with accessing and receiving ART (12.6%), job insecurity arising from regular leave of absence to receive ART (2%), shortage of drugs and other commodities (13.3%), fear of side effects of taking ARVs (4.8%), and stigma (1.3%). These barriers are very similar to what has been documented in other previous studies elsewhere [7, 14, 17–21] and in Ghana more specifically [9, 11]. …”

Section: Discussionsupporting

confidence: 90%

“…face barriers accessing ART) is unknown in the four study sites. Based on previous literature [9, 14] we estimated that 50% of the total number of HIV+ persons on ART from the four study sites face one barrier or the other accessing ART. With an alpha of 0.05 and a statistical power of 90%, 434 clients were computed as the minimum sample needed to assess the barriers HIV+ persons face accessing ART from the four treatment centres.…”

Section: Methodsmentioning

confidence: 99%

“…Limited trained health staff [12–14], lack of comfortable hospital facilities to provide ART [15, 16], shortages and unavailability of ART in certain places especially in low-income settings [17, 18], high costs, including travel, opportunity and social costs associated with ART [7, 19], are some of the most commonly cited barriers HIV+ persons face in accessing ART. Fear of side effects [20], fear of stigma and discrimination [14, 21] and lack of adequate social support [22] have also been reported as formidable barriers hindering access to ART.…”

Section: Introductionmentioning

confidence: 99%

“…While these pioneering studies in Ghana have highlighted some of the barriers to accessing ART, they nevertheless have not paid sufficient attention to the perspectives of PLH. Understanding the perspectives of PLH in relation to the barriers they face in accessing ART could however form the basis for implementing contextually relevant programmatic initiatives to both redress these challenges and better improve access and adherence to ART [14]. This paper presents and discusses access –related barriers that HIV+ persons already linked to ART in southern Ghana face.…”

Section: Introductionmentioning

confidence: 99%

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ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study

et al. 2016

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BackgroundTimely and enduring access to antiretroviral therapy (ART) by HIV-infected individuals has been shown to substantially reduce HIV transmission risk, HIV-related morbidity and mortality. However, there is evidence that in addition to limited supply of antiretrovirals (ARVs) and linkage to ART in many low-income countries, HIV+ persons often encounter barriers in accessing ART-related services even in contexts where these services are freely available. In Ghana, limited research evidence exists regarding the barriers HIV+ persons already linked to ART face. This paper explores ART access–related barriers that HIV+ persons linked to care in southern Ghana face.MethodsA mixed method study design, involving a cross-sectional survey and qualitative in-depth interviews, was conducted to collect data from four healthcare providers and a total of 540 adult HIV+ persons receiving ART at four treatment centres in Ghana. We used univariate analysis to generate descriptive tabulations for key variables from the survey. Data from qualitative in-depth interviews were thematically analysed. Results from the survey and in-depth interviews were brought together to illuminate the challenges of the HIV+ persons.ResultsAll (100%) the HIV+ persons interviewed were ARV-exposed and linked to ART. Reasons for taking ARVs ranged from beliefs that they will suppress the HIV virus, desire to maintain good health and prolong life, and desire to prevent infection in unborn children, desire both to avoid death and to become good therapeutic citizens (abide by doctors’ advice). Despite this, more than half of the study participants (63.3%) reported seven major factors as barriers hindering access to ART. These were high financial costs associated with accessing and receiving ART (26%), delays associated with receiving care from treatment centres (24%), shortage of drugs and other commodities (23%), stigma (8.8%), fear of side effects of taking ARVs (7.9%), job insecurity arising from regular leave of absence to receive ART (5.3%), and long distance to treatment centres (4.9%).ConclusionsThe results in this study suggest that efforts to provide and scale-up ART to all HIV+ persons must be accompanied by interventions that address structural and individual level access barriers.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2075-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study

et al. 2016

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“…22,23,24 The community related barriers include stigma and discrimination against people living with HIV/AIDS, gender discrimination against women living with the virus, interference with ART treatment by some religious leaders, ethical contentions due to high cost of antiretroviral drugs. 21,25,26,27,28…”

Section: Resultsmentioning

confidence: 99%

Barriers to HIV/AIDS Treatment in Nigeria

Saleh¹,

Adamu²

2015

AJHR

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Background: With the exception of South Africa and India, the number people living with Human Immunodeficiency Virus (PLWHA) in Nigeria exceeds that of any other country in the World. Access to HIV/AIDS treatment services remains a challenge as only 6% of PLWHAs have accessed the services. This stands in the way of achieving the National HIV/AIDS policy as well as the global goal of placing 15 million PLWHAs on treatment and care by the end of the year 2015. In order to achieve these goals, there is need to know the barriers (through systematic literature review) that prevent access to HIV/AIDS treatment especially in the developing world of sub-Saharan Africa (of which Nigeria is among) that houses 70% of global HIV/AIDS burden. When these barriers are known, strategies would then be adopted to remove them so as to improve the treatment coverage. Study Design: Systematic review. Methods: Twenty studies looking at issues surrounding barriers preventing access to HIV/AIDS treatment and support services in Nigeria and other developing countries were reviewed in order to identify key issues or barriers militating against the smooth delivery of HIV/AIDS treatment services and recommend strategies for removing them in order to achieve the much desired universal access to HIV treatment. Results: Suggest that the barriers to HIV/AIDS treatment in the developing world are grouped into three categories namely health systems related, patients related and community related. Conclusion: Sequel to the literature review findings, stakeholders must come together and agree on a sustainable and community driven approach to HIV/AIDS treatment in Nigeria.

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Quality of TB care among people living with HIV: Gaps and solutions

Naidoo

Gengiah

Singh

et al. 2019

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Tuberculosis (TB) is the leading infectious cause of death among people living with HIV, causing one third of AIDS-related deaths globally. The concerning number of missing TB cases, ongoing high TB mortality, slow reduction in TB incidence, and limited uptake of TB preventive treatment among people living with HIV, all indicate the urgent need to improve quality of TB services within HIV programs. In this mini-review we discuss major gaps in quality of TB care that impede achieving prevention and treatment targets within the TB-HIV care cascades, show approaches of assessing gaps in TB service provision, and describe outcomes from innovative quality improvement projects among HIV and TB programs. We also offer recommendations for measuring quality of TB care.

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Barriers to access to antiretroviral treatment for HIV-positive tuberculosis patients in Windhoek, Namibia

Abstract: The study identified access barriers to ART for HIV-positive TB patients and their relevance in Namibia. The findings provide evidence for tailored interventions to increase ART-uptake among HIV-positive TB patients.

Cited by 14 publications

References 16 publications

ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study

ART access-related barriers faced by HIV-positive persons linked to care in southern Ghana: a mixed method study

Barriers to HIV/AIDS Treatment in Nigeria

Quality of TB care among people living with HIV: Gaps and solutions

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