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Research Article
Omobola Mudasiru
University of California, Berkeley
Corresponding Author
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Background Tanzania adopted WHO’s universal test and treat policy in 2016, recommending antiretroviral therapy (ART) for all people living with HIV (PLHIV). However, many individuals continue to confront challenges initiating or continuing ART. The study aims to understand how barriers and facilitators to ART have evolved since Test and Treat policy in Tanzania.
Between March and June 2018, 25 semi-structured in-depth interviews were conducted among PLHIV who were out of care, including PLHIV who never initiated ART and PLHIV who were formerly in care and discontinued ART. Participants were 18-years-old or older, identified from clinic databases at three health facilities and through home-based care providers. Data were coded and interpreted using content analysis and the socio-ecological framework.
Results Low HIV literacy, poor quality of health messaging and comprehension, stigma, structural factors, and poverty were identified as main barriers to care. HIV literacy appeared higher among those formerly in care and some misconceptions about ART differed whether or not participants had previously initiated treatment. Participants expressed desire for more information about their health and treatment, including more engagement with their healthcare providers.
Conclusions Our results are consistent with the barriers and facilitators to care reported prior to the implementation of the Test and Treat policy. Despite universal access to care, limited progress has been made in addressing the underlying challenges that PLHIV confront in initiating and continuing ART. Efforts such as increase in HIV literacy, improve health messaging, and strengthen healthcare provider-to-patient communication will facilitate access to care. The policy implication of these findings is that the landscape for barriers to ART has not changed drastically, efforts towards engagement to care need to be further refined and tailored to facilitate access to care.
Keywords
HIV, Linkage, Barriers, Healthcare, Social ecological model, Tanzania, Test and Treat
No competing interests reported.
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research Article
Omobola Mudasiru
University of California, Berkeley
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 27 Jan, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Tanzania adopted WHO’s universal test and treat policy in 2016, recommending antiretroviral therapy (ART) for all people living with HIV (PLHIV). However, many individuals continue to confront challenges initiating or continuing ART. The study aims to understand how barriers and facilitators to ART have evolved since Test and Treat policy in Tanzania.
Between March and June 2018, 25 semi-structured in-depth interviews were conducted among PLHIV who were out of care, including PLHIV who never initiated ART and PLHIV who were formerly in care and discontinued ART. Participants were 18-years-old or older, identified from clinic databases at three health facilities and through home-based care providers. Data were coded and interpreted using content analysis and the socio-ecological framework.
Results Low HIV literacy, poor quality of health messaging and comprehension, stigma, structural factors, and poverty were identified as main barriers to care. HIV literacy appeared higher among those formerly in care and some misconceptions about ART differed whether or not participants had previously initiated treatment. Participants expressed desire for more information about their health and treatment, including more engagement with their healthcare providers.
Conclusions Our results are consistent with the barriers and facilitators to care reported prior to the implementation of the Test and Treat policy. Despite universal access to care, limited progress has been made in addressing the underlying challenges that PLHIV confront in initiating and continuing ART. Efforts such as increase in HIV literacy, improve health messaging, and strengthen healthcare provider-to-patient communication will facilitate access to care. The policy implication of these findings is that the landscape for barriers to ART has not changed drastically, efforts towards engagement to care need to be further refined and tailored to facilitate access to care.
No competing interests reported.
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