The Comorbidity of HIV, Hypertension and Diabetes: A Qualitative Study Exploring the Challenges Faced by Healthcare Providers and Patients in Selected Urban and Rural Health Facilities where the ICDM Model is Implemented in South Africa

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Abstract BackgroundPeople living with HIV (PLWH) are living longer as a result of advancement and adherence to antiretroviral therapy. As the life expectancy of PLWH increases, they are at increased risk of hypertension. MethodsWe conducted 24 in-depth interviews to understand the challenges faced by healthcare providers and PLWH with chronic comorbidities under the Integrated Chronic Disease Management (ICDM) model implemented in health facilities in South Africa. Thematic content analysis was conducted. ResultsThe challenges experienced included lack of staff capacity, unclear guidelines on the delivery of integrated care for patients with HIV chronic comorbidities, pill burden, non-disclosure, financial burden, poor knowledge of treatments, relocation of patients and access to treatment. Lack of support and integrated chronic programmes including minimal information regarding the management of HIV chronic comorbidities were another concern. ConclusionStandardised guidelines and training, increasing staff capacity and addressing socio-economic barriers is critical to achieving the outcomes of the ICDM.

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