Barriers to adherence and retention in public and private healthcare according to patients and health workers
Abstract
Introduction: The National Program of AIDS guarantees universal access to antiretroviral medication, yet people receiving treatment through the public healthcare system do not achieve an undetectable viral load in the same rate than patients in the private system. This qualitative study aims to identify factors associated with adherence and retention in the HIV-cascade of care at public and private setting from Buenos Aires, based on patients and healthcare workers’ perceptions.
Methods: Qualitative data from 12 semi-structured interviews with key informants and 4 focus groups of patients and healthcare workers from the public and private systems were recorded. Transcripts were coded and analyzed, using the QRS Nvivo9® software for qualitative data analysis, into set themes on adherence.
Results: Patients and healthcare workers of both systems agree on the importance of HIV-related stigma, professional-patient relationship and communication, and the division of treatment-related responsibilities as fundamental aspects for adherence and retention in the HIV-cascade of care. Differences in the manner these factors interact were observed between healthcare systems. Structural barriers are presented as the main adherence barrier in the public system.
Discussion: The need for interventions focused on the doctor-patient dyad considering the features of each healthcare is highlighted in order to facilitate patient engagement in adherence.
Downloads
Copyright (c) 2023 Inés Arístegui, Analía Dorigo, Lina Bofill, Alejandra Bordatto, Mar Lucas, Graciela Fernández Cabanillas, Omar Sued, Pedro Cahn, Isabel Cassetti, Stephen Weiss, Deborah Jones
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
When an article is finally accepted in the journal, its authors assign their economic rights on a non-exclusive basis in favor of the editors, who allow reuse under an “Attribution-NonCommercial-ShareAlike 4.0 International” License (https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es). This implies that the articles can be shared (copy and redistribute the material in any medium or format) and adapted (remix, transform and create another work from the material), as long as the authorship and the original source of publication (journal, publisher and URL of the work) are cited, they are not used for commercial purposes, and the same terms of the license are respected. It is requested to cite the original source of publication.
In addition, the acceptance of the article by the journal implies on the part of the authors the non-submission of the material to other journals or editorial bodies.
