Your browser doesn't support javascript.
loading
'Not taking medications and taking medication, it was the same thing:' perspectives of antiretroviral therapy among people hospitalised with advanced HIV disease.
Loveday, Marian; Hlangu, Sindisiwe; Manickchund, Pariva; Govender, Thiloshini; Furin, Jennifer.
Afiliación
  • Loveday M; HIV and Other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, 491 Peter Mokaba Ridge Road, Overport, Durban, KwaZulu-Natal, South Africa. marian.loveday@mrc.ac.za.
  • Hlangu S; Centre for Health Systems Research & Development, University of the Free State, Bloemfontein, South Africa. marian.loveday@mrc.ac.za.
  • Manickchund P; CAPRISA-MRC HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa. marian.loveday@mrc.ac.za.
  • Govender T; HIV and Other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council, 491 Peter Mokaba Ridge Road, Overport, Durban, KwaZulu-Natal, South Africa.
  • Furin J; Internal Medicine, King Edward VIII Hospital, KwaZulu-Natal Department of Health, University of KwaZulu-Natal, Durban, South Africa.
BMC Infect Dis ; 24(1): 819, 2024 Aug 13.
Article en En | MEDLINE | ID: mdl-39138390
ABSTRACT

BACKGROUND:

Despite HIV's evolution to a chronic disease, the burden of advanced HIV disease (AHD, defined as a CD4 count of < 200 cells/uL or WHO clinical Stage 3 or 4 disease), remains high among People Living with HIV (PLHIV) who have previously been prescribed antiretroviral therapy (ART). As little is known about the experiences of patients hospitalised with AHD, this study sought to discern social forces driving hospitalisation with AHD. Understanding such forces could inform strategies to reduce HIV-related morbidity and mortality.

METHODS:

We conducted a qualitative study with patients hospitalised with AHD who had a history of poor adherence. Semi-structured interviews were conducted between October 1 and November 30, 2023. The Patient Health Engagement and socio-ecological theoretical models were used to guide a thematic analysis of interview transcripts.

RESULTS:

Twenty individuals participated in the research. Most reported repeated periods of disengagement with HIV services. The major themes identified as driving disengagement included 1) feeling physically well; 2) life circumstances and relationships; and 3) health system factors, such as clinic staff attitudes and a perceived lack of flexible care. Re-engagement with care was often driven by new physical symptoms but was mediated through life circumstances/relationships and aspects of the health care system.

CONCLUSIONS:

Current practices fail to address the challenges to lifelong engagement in HIV care. A bold strategy for holistic care which involves people living with advanced HIV as active members of the health care team (i.e. 'PLHIV as Partners'), could contribute to ensuring health care services are compatible with their lives, reducing periods of disengagement from care.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Investigación Cualitativa / Cumplimiento de la Medicación / Hospitalización Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Investigación Cualitativa / Cumplimiento de la Medicación / Hospitalización Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido