Social constraints to TB/HIV healthcare: accounts from coinfected patients in South Africa.
MetadataShow full item record
There is a growing imperative to improve the coordination and collaboration of tuberculosis (TB) and HIV healthcare services in response to escalating rates of TB/HIV coinfection. Patient-specific challenges associated with the delivery of TB/HIV care have been minimally explored in this regard. As part of a larger study conducted in South Africa, this article highlights coinfected patients’ experiences with TB and HIV healthcare in light of their broader social environments. Qualitative, in-depth interviews were conducted with 40 adult, coinfected patients (24 women and 16 men) and eight key-informant healthcare workers at three urban/peri-urban, ambulatory, public health clinics in the high-burden province of KwaZulu-Natal. Transcribed interviews were analyzed under a modified grounded theory approach to capture subjective meanings of healthcare experience subsequent to patients’ codiagnosis with TB and HIV. Emerging analytic themes highlighted critical sociomedical constraints to TB/HIV care in relation to patients’ income and employment, eligibility for social assistance and antiretroviral treatment, fears around illness disclosure, social and material support, and treatment adherence. Patients’ healthcare experiences were bound by their poor access to essential resources, multiple life responsibilities, disparate gender roles, limits within the healthcare system, and the stigmatizing social symbolism of their illness. Overlapping social inequalities perpetuated coinfected patients’ experiences with stigma and collectively mediated their health decisions around disclosure, adherence, and retention in medical care. The study urges a contextualized understanding of the social challenges associated with TB/HIV healthcare and helps inform more patient-sensitive and socially responsive interventions against the co-epidemic.
Showing items related by title, author, creator and subject.
Maarschalk, Silvia. (2007)The South African context gives rise to a number of significant adversities that challenge the stability of the individual child and the survival of their families. The repercussions of these adversities are profound. Once ...
Bollapragada, Madhuri Katyayani.Universities are beginning to embrace social media and realizing the potential power and implications of using social networking sites such as Facebook as a communication tool to reach its target audience. It has become ...
The development and evaluation of a community-based programme offering psychosocial support to vulnerable children affected by HIV/AIDS, poverty and violence. Killian, Beverley Janet. (2004)This research programme endeavours to develop, implement and evaluate an effective method of offering psychosocial support to vulnerable children. Vulnerability is defined by trained community members as including children ...