Healthcare providers’ perspective on barriers to optimal HIV index testing: an interview-based study
Résumé
Background HIV testing services (HTS) and antiretroviral therapy have seen a substantial scale-up while poorly targeted HTS have continued to miss people living with HIV who do not know their HIV status. This requires new and targeted approaches to reach undiagnosed people with HIV, such as HIV partner services. The aim of this study was to assess the barriers to optimal index testing and explore the interventions to improve HIV testing yield in Lusaka, Zambia. Methods One-to-one interviews were conducted with index testing providers to explore provider-related and client-related barriers to testing, and document other experiences arising during the process of HIV index testing. An interview guide was utilized for consistency of information collected. Results Provider related challenges included inadequate elicitation skills among healthcare workers; low number of volunteers trained in index testing; inadequate index testing knowledge among staff; age and sex differences (difficulties to obtain more information from younger or older clients and those of opposite gender); limited elicitation of index partners to only wife and husband (not eliciting all sexual partners); limited logistics for contact tracing; and limited space dedicated to conduct elicitation of index clients. On the other hand, client-related challenges were mobile communities due to seasonal activities such as cross boarder trades and farming; sex work; some key populations and adolescent index clients do not have contact details for their casual relationships; provider’s old or younger age as compared to the client or opposite gender for some clients; missing details on client locator forms or wrong details provided; and stigma and discrimination. Conclusion Our study underscores the critical need for age and gender sensitivity in HIV index testing practices. The findings indicate that both client and provider perceptions are significantly influenced by demographic factors, which can impact testing uptake, overall engagement in care, and adherence to treatment. We observed that clients of different ages and genders experience unique barriers and facilitators that shape their interactions with healthcare providers, ultimately affecting the outcomes of HIV testing initiatives.
Citer ce document
Accès au document
Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter
Voir l'article sur le site de la revueAuteur(s)
Statistiques
Consultations : 1
Téléchargements : 0