Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine
Abstract Background Engagement with HIV medical care is critical to successful HIV treatment and prevention efforts. However, in Ukraine, delays in the timely initiation of HIV treatment hamper viral suppression. By January 01, 2016, only 126,604 (57.5%) of the estimated 220,000 people living with H...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-2885-4 |
| _version_ | 1818296078075691008 |
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| author | Tetiana Kiriazova Oleksandr Postnov Trista Bingham Janet Myers Timothy Flanigan Charles Vitek Oleksandr Neduzhko |
| author_facet | Tetiana Kiriazova Oleksandr Postnov Trista Bingham Janet Myers Timothy Flanigan Charles Vitek Oleksandr Neduzhko |
| author_sort | Tetiana Kiriazova |
| collection | DOAJ |
| description | Abstract Background Engagement with HIV medical care is critical to successful HIV treatment and prevention efforts. However, in Ukraine, delays in the timely initiation of HIV treatment hamper viral suppression. By January 01, 2016, only 126,604 (57.5%) of the estimated 220,000 people living with HIV (PLWH) had registered for HIV care, and most (55.1%) of those who registered for HIV care in 2015 did that at a late stage of infection. In the US, Anti-Retroviral Treatment and Access to Services (ARTAS) intervention successfully linked newly diagnosed PLWH to HIV services using strengths-based case management with a linkage coordinator. To tailor the ARTAS intervention for Ukraine, we conducted a qualitative study with patients and providers to understand barriers and facilitators that influence linkage to HIV care. Methods During September–October 2014, we conducted 20 in-depth interviews with HIV-positive patients and two focus groups with physicians in infectious disease, sexually transmitted infection (STI), and addiction clinics in Dnipropetrovsk Region of Ukraine. Interviews and focus groups were audio-recorded and transcribed verbatim. We translated illustrative quotes into English. We used thematic analysis for the data analysis. Results Participants (20 patients and 14 physicians) identified multiple, mostly individual-level factors influencing HIV care initiation. Key barriers included lack of HIV knowledge, non-acceptance of HIV diagnosis, fear of HIV disclosure, lack of psychological support from health providers, and HIV stigma in community. Responsibility for one’s health, health deterioration, and supportive provider communication were reported as facilitators to linkage to care. Expected benefits from the case management intervention included psychological support, HIV education, and help with navigating the segmented health system. Conclusions The findings from the study will be used to optimize the ARTAS for the Ukrainian context. Our findings can also support future linkage-to-care strategies in other countries of Eastern Europe and Central Asia. |
| first_indexed | 2024-12-13T03:57:49Z |
| format | Article |
| id | doaj.art-c972e9f2947e4b34adcebaab1a7f8376 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-13T03:57:49Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-c972e9f2947e4b34adcebaab1a7f83762022-12-22T00:00:34ZengBMCBMC Health Services Research1472-69632018-01-011811910.1186/s12913-018-2885-4Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in UkraineTetiana Kiriazova0Oleksandr Postnov1Trista Bingham2Janet Myers3Timothy Flanigan4Charles Vitek5Oleksandr Neduzhko6Ukrainian Institute on Public Health PolicyUkrainian Institute on Public Health PolicyDivision of Global HIV and Tuberculosis, Centers for Global Health, U.S. Centers for Disease Control and PreventionDivision of Prevention Science, University of California, San FranciscoWarren Alpert Medical School, Brown UniversityDivision of Global HIV and Tuberculosis, Centers for Global Health, U.S. Centers for Disease Control and PreventionUkrainian Institute on Public Health PolicyAbstract Background Engagement with HIV medical care is critical to successful HIV treatment and prevention efforts. However, in Ukraine, delays in the timely initiation of HIV treatment hamper viral suppression. By January 01, 2016, only 126,604 (57.5%) of the estimated 220,000 people living with HIV (PLWH) had registered for HIV care, and most (55.1%) of those who registered for HIV care in 2015 did that at a late stage of infection. In the US, Anti-Retroviral Treatment and Access to Services (ARTAS) intervention successfully linked newly diagnosed PLWH to HIV services using strengths-based case management with a linkage coordinator. To tailor the ARTAS intervention for Ukraine, we conducted a qualitative study with patients and providers to understand barriers and facilitators that influence linkage to HIV care. Methods During September–October 2014, we conducted 20 in-depth interviews with HIV-positive patients and two focus groups with physicians in infectious disease, sexually transmitted infection (STI), and addiction clinics in Dnipropetrovsk Region of Ukraine. Interviews and focus groups were audio-recorded and transcribed verbatim. We translated illustrative quotes into English. We used thematic analysis for the data analysis. Results Participants (20 patients and 14 physicians) identified multiple, mostly individual-level factors influencing HIV care initiation. Key barriers included lack of HIV knowledge, non-acceptance of HIV diagnosis, fear of HIV disclosure, lack of psychological support from health providers, and HIV stigma in community. Responsibility for one’s health, health deterioration, and supportive provider communication were reported as facilitators to linkage to care. Expected benefits from the case management intervention included psychological support, HIV education, and help with navigating the segmented health system. Conclusions The findings from the study will be used to optimize the ARTAS for the Ukrainian context. Our findings can also support future linkage-to-care strategies in other countries of Eastern Europe and Central Asia.http://link.springer.com/article/10.1186/s12913-018-2885-4HIV careLinkage to careARTASInterventionUkraine |
| spellingShingle | Tetiana Kiriazova Oleksandr Postnov Trista Bingham Janet Myers Timothy Flanigan Charles Vitek Oleksandr Neduzhko Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine BMC Health Services Research HIV care Linkage to care ARTAS Intervention Ukraine |
| title | Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine |
| title_full | Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine |
| title_fullStr | Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine |
| title_full_unstemmed | Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine |
| title_short | Patient and provider perspectives inform an intervention to improve linkage to care for HIV patients in Ukraine |
| title_sort | patient and provider perspectives inform an intervention to improve linkage to care for hiv patients in ukraine |
| topic | HIV care Linkage to care ARTAS Intervention Ukraine |
| url | http://link.springer.com/article/10.1186/s12913-018-2885-4 |
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