Abstract:ObjectiveTo explore how the COVID-19 pandemic affected access to antiretroviral therapy (ART) services from the perspective of the persons living with HIV (PLWH).DesignThe study adopted an exploratory-descriptive qualitative design that used in-depth interviews as the technique for the data collection. Data analysis was done using conceptual content analysis, following the traditions of Elo and Kyngäs on deductive and Hsieh on inductive content analysis.SettingART clinic, Cape Coast Teaching Hospital, Ghana.Pa… Show more
“…While increased structural barriers to accessing treatment (e.g., longer wait times) negatively impacted participant perceptions of care, reduced privacy during care interactions was described as the primary challenge negatively affecting the quality and breadth of clinical consultation. Broadly, findings align with those of qualitative studies conducted in other settings, which have identified both new and increased barriers for PWH during the pandemic 14–17,19,20 and differ from prior qualitative work in South Africa, which was conducted within a program for highly adherent PWH. 13 Figure 1.Conceptual map of themes.…”
Background The COVID-19 pandemic had a global impact on health systems and the delivery of health services, including for chronic conditions such as HIV. In South Africa, impacts on HIV services have widely been quantitatively described. Across different health settings, patients have also qualitatively described numerous negative impacts to their HIV care. However, patient perspectives on COVID-19 impacts to HIV care in South Africa, the largest HIV care system in the world, have been little explored to date. Methods We conducted 29 semi-structured individual interviews with people living with HIV ( n = 24) and providers ( n = 5) in Cape Town, South Africa. Results While most patient participants reported continued access to HIV treatment during the pandemic, many described perceiving that the quality of their care declined. Increased structural barriers were described as one contributing factor to this change. Additionally, patients described that reduced privacy in clinical interactions was a key factor negatively influencing their experience of receiving care. Conclusion Findings underscore the importance of ensuring patient privacy for HIV services even during the rearrangement of services in emergencies. It is also important to continue developing models to integrate community mental health services within HIV care delivery in South Africa.
“…While increased structural barriers to accessing treatment (e.g., longer wait times) negatively impacted participant perceptions of care, reduced privacy during care interactions was described as the primary challenge negatively affecting the quality and breadth of clinical consultation. Broadly, findings align with those of qualitative studies conducted in other settings, which have identified both new and increased barriers for PWH during the pandemic 14–17,19,20 and differ from prior qualitative work in South Africa, which was conducted within a program for highly adherent PWH. 13 Figure 1.Conceptual map of themes.…”
Background The COVID-19 pandemic had a global impact on health systems and the delivery of health services, including for chronic conditions such as HIV. In South Africa, impacts on HIV services have widely been quantitatively described. Across different health settings, patients have also qualitatively described numerous negative impacts to their HIV care. However, patient perspectives on COVID-19 impacts to HIV care in South Africa, the largest HIV care system in the world, have been little explored to date. Methods We conducted 29 semi-structured individual interviews with people living with HIV ( n = 24) and providers ( n = 5) in Cape Town, South Africa. Results While most patient participants reported continued access to HIV treatment during the pandemic, many described perceiving that the quality of their care declined. Increased structural barriers were described as one contributing factor to this change. Additionally, patients described that reduced privacy in clinical interactions was a key factor negatively influencing their experience of receiving care. Conclusion Findings underscore the importance of ensuring patient privacy for HIV services even during the rearrangement of services in emergencies. It is also important to continue developing models to integrate community mental health services within HIV care delivery in South Africa.
“…This phenomenon corroborates findings recorded among HIV patients. 29 If not checked, efforts made at achieving the Sustainable Development Goals (SDG) target 3.4 that seeks to promote life and health for persons living with non-communicable diseases (NCDs) through prevention and treatment 30 , 31 will be eroded.…”
The COVID-19 pandemic resulted in disruption in every facet of life including health service delivery. This has threatened the attainment of global targets to improve health and wellbeing of all persons. In particular, for persons living with chronic diseases, who require consistent monitoring by health professionals and medication to enhance their health, understanding how the pandemic has disruption their access to health care delivery is critical for interventions aimed at improving health service delivery for all as well as preparedness for future pandemic. This study applied the constructs of the Health Belief Model, to explore the influences of the COVID-19 pandemic on the health seeking behaviors of persons living with chronic diseases. The design was exploratory descriptive. Semi-structured interviews were conducted to collect data among persons living with chronic diseases in the Cape Coast Metropolis of Ghana. Thematic analysis, both inductive and deductive, was conducted to unearth the findings. Awareness of increased susceptibility and risk of a more severe episode if they contracted COVID-19 as a result of the existing chronic diseases was identified. Lack of access to health professionals during the peak of the pandemic as well as the fear of contracting the virus while accessing their regular chronic disease clinic was the main barriers identified. Information in the media served as cues to action for adopting preventive health strategies. Behavior modifications; dietary and lifestyle, self-medication and adoption of COVID-19 related precautions were practiced. Susceptibility to contracting COVID-19 contributed to missed adherence to treatment appointment. The health belief model was a useful framework in exploring the health seeking behavior of the adults living with chronic conditions during the COVID-19 in this study setting. Intensifying targeted education for persons living with chronic diseases will contribute to the adoption of positive health seeking behaviors during future pandemic.
“…Other barriers to health care access include decreased use of healthcare services due to country measures on elective care, fear of contagion and stigma; low health literacy [23,41], and inability to access services due to low socioeconomic status and poor competency to use technologies [35]. Prior studies indicated that people with needs for antiretroviral therapy [42], sexual and reproductive health services [43] and tuberculosis services [7,44] among others, had difficulty accessing services during the COVID-19 pandemic.…”
Background
Healthcare services were significantly interrupted during the early phase of the COVID-19 pandemic. The aim of the present study was to determine the associations between sociodemographic factors and healthcare access during the first wave of the COVID-19 pandemic among individuals with critical care needs.
Methods
This was a secondary analysis of the data of 5,156 participants recruited from 152 countries during the first wave of the COVID-19 pandemic. The dependent variables were self-reported difficulty of access to health care, challenges with obtaining medication, and the use of alternative medical services. The independent variables were age at last birthday; sex at birth, level of education, employment status and the macro-social vulnerability status. The confounding variable was the country income level. Three multivariable logistic regression analyses were conducted to determine the associations between the dependent variables and the independent variables after adjusting for the confounder.
Results
Difficulty accessing health care services and obtaining medications was experienced by 1922 (37.3%) and 3746 (72.7%) participants respectively. Also, 1433 (27.8%) used alternative medical care. Retirees (AOR:1.59), unemployed (AOR:1.198), people living with HIV (AOR:2.36) and at increased risk of COVID-19 (AOR:2.10), people who used drugs (AOR:1.83) and transacted sex (AOR:1.971) had significantly higher odds for reporting difficulty with access to health care. Males (AOR:1.23), respondents with secondary level of education (AOR:1.39), retirees (AOR:2.19), unemployed (AOR:1.47), people living with HIV (AOR:2.46), people who used drugs (AOR:1.79), transacted sex (AOR:2.71) and those who might be (AOR: 1.66) and were at (AOR: 2.3) increased risk of severe COVID-19 had significantly higher odds for reporting difficulty with access to medications. People who used drugs (AOR:2.093) transacted sex (AOR:1.639), who might be (AOR: 1.211) and were at (AOR: 1.511) increased risk of severe COVID-19, and who had difficulty accessing usual healthcare (AOR: 9.047) and obtaining medications (AOR:2.16) had significantly higher odds of reporting alternative medical care use. People living with HIV (AOR:0.562) had significantly lower odds of using alternative medical care.
Conclusion
We identified populations who had challenges with access to healthcare and obtaining medications used alternative medical care except for people living with HIV. Priority attention should be given to alternative medical care use during future health pandemics.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
