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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Barriers to accessing antiretroviral therapy in Kisesa, Tanzania: A qualitative study of early rural referrals to the national program
AIDS Patient Care and STDs, Volume 20, No. 9, Year 2006
Notification
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Description
This community-based, qualitative study conducted in rural Kisesa District, Tanzania, explores perceptions and experiences of barriers to accessing the national antiretroviral programme among self-identified HIV-positive persons. Part of wider operations research around local introduction of HIV therapy, the study involved consultation with villagers and documented early referrals' progress through clinical evaluation and, if eligible, further training and drug procurement. Data collection consisted of 16 participatory group discussions with community members and 18 in-depth interviews with treatment-seekers. Although participants welcomed antiretroviral therapy, they feared that transportation and supplementary food costs, the referral hospital's reputation for being unfriendly and confusing, and difficulties in sustaining long-term treatment would limit accessibility. Fear of stigma framed all concerns, posing challenges for contacting referrals who did not want their status disclosed or expressed reluctance to identify a "treatment buddy" as required by the programme. To mitigate logistical barriers, transportation costs were paid and hospital visits facilitated. Participants reported satisfaction with eligibility testing, finding the process easier than anticipated. Most were willing to join a support group and some changed attitudes toward disclosure. However, both experienced and anticipated discrimination continue to hinder widespread antiretroviral therapy (ART) uptake. While simple measures to reduce perceived barriers improved initial access to treatment and helped overcome anxiety among early referrals, pervasive stigma remains the most formidable barrier. Encouraging successful referrals to share their positive experiences and contribute to nascent community mobililzation could start to address this seemingly intractable problem. © Copyright 2006, Mary Ann Liebert, Inc.
Authors & Co-Authors
Mshana, Gerry Hillary
Unknown Affiliation
Wamoyi, Joyce
Unknown Affiliation
Busza, Joanna
Unknown Affiliation
Zaba, Basia W.
Unknown Affiliation
Changalucha, John M.
Unknown Affiliation
Kaluvya, Samuel
Unknown Affiliation
Urassa, Mark S.
Unknown Affiliation
Statistics
Citations: 205
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1089/apc.2006.20.649
ISSN:
10872914
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Mental Health
Study Design
Grounded Theory
Study Approach
Qualitative
Study Locations
Tanzania