AI Article Synopsis

  • HIV prevalence in the Democratic Republic of Congo (DRC) is low at 1.2%, but people often delay seeking healthcare until advanced stages of HIV due to factors like stigma and economic issues.
  • A qualitative study in Kinshasa involved interviews with 24 participants (health-care workers, patients, caregivers) to explore reasons for delays in treatment access, revealing that many feared disclosing their HIV status and struggled with affordability of care.
  • The study concluded that addressing stigma, promoting education around treatment options, and improving access to free healthcare are essential steps needed to reduce the number of people presenting with advanced HIV.

Article Abstract

Introduction: HIV prevalence in the Democratic Republic of Congo (DRC) is estimated to be 1.2%, and access to HIV testing and treatment remains low across the country. Despite advances in treatment, HIV continues to be one of the main reasons for hospitalisation and death in low- and middle-income countries, including DRC, but the reasons why people delay seeking health-care when they are extremely sick remain little understood. People in Kinshasa, DRC, continue to present to health-care facilities in an advanced stage of HIV when they are close to death and needing intensive treatment.

Methods: This qualitative study was conducted in one health-care facility in Kinshasa. A total of 24 in-depth interviews with purposively selected health-care workers, patients and care-givers were conducted. Patients were currently or previously hospitalised with advanced HIV, defined as CD4 count <200 cells/μl. Patients included those who had previously started antiretroviral treatment (ART), and those who had not. Participant observation was also carried out. Interviews were audio-recorded, translated from French and Lingala into English, transcribed, coded and thematically analysed using NVivo.

Results: The main reasons for delaying access to health-care were stigmatisation, religious beliefs and limited economic resources. Stigmatisation meant that people feared disclosing their HIV status and thus did not receive support from their families. Religious leaders were reported to have encouraged people not to take ART. Patients delayed seeking treatment as they could not afford it, and health-care workers believed that staff at other facilities in Kinshasa were delaying HIV diagnoses for economic benefit.

Conclusions: Delays in accessing care and treatment linked to stigma, religious beliefs and economic factors contribute to explaining the persistence of advanced HIV within this context. Access to free HIV-testing, ART and treatment of opportunistic infections; counselling; training of health-care workers; support for care-givers and stigma reduction strategies are urgently needed to prevent unnecessary deaths.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373965PMC
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211619PLOS

Publication Analysis

Top Keywords

advanced hiv
8
democratic republic
8
republic congo
8
hiv
6
"even she's
4
she's sick
4
sick will
4
will pretend
4
pretend fine"
4
fine" delays
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!