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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Social constraints to TB/HIV healthcare: Accounts from coinfected patients in South Africa
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, Volume 24, No. 12, Year 2012
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Description
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. © 2012 Copyright Taylor and Francis Group, LLC.
Authors & Co-Authors
Daftary, Amrita
United States, New York
Mailman School of Public Health
Padayatchi, Nesri
South Africa, Congella
Centre for the Aids Programme of Research in South Africa
Statistics
Citations: 67
Authors: 2
Affiliations: 2
Identifiers
Doi:
10.1080/09540121.2012.672719
ISSN:
09540121
e-ISSN:
13600451
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Grounded Theory
Study Approach
Qualitative
Study Locations
South Africa
Participants Gender
Male
Female