Health Needs of People Living with HIV/AIDS: From the Perspective of Policy Makers, Physicians and Consultants, and People Living with HIV/AIDS (original) (raw)

Exploring the determinants of health service utilization among people living with HIV: a qualitative study in Iran

BMC Health Services Research, 2023

Background Health service utilization among people living with HIV is vital for their survival and quality of life. This study aims to exploring the determinants influencing health service utilization among people living with HIV. Methods We conducted a qualitative study involving 16 men and women aged 18-64 living with HIV in Tehran. Data were collected between September and December 2021 through semi-structured interviews conducted via telephone and online platforms, utilizing the purposeful sampling method. Data were analyzed by MAXQDA-2018 software using conventional content analysis approaches and the Granheim and Landman method. Results Two main themes, seven categories, and 21 subcategories were obtained from the interviews. The main themes included facilitators of health service utilization (positive personality traits, social factors, and structuralbehavioral determinants) and inhibitors of health service utilization (personal conditions, insufficient knowledge and understanding of the disease, negative consequences of disease disclosure, and difficult access to services). Conclusion This study underscores the need to invest and expand specialized services for people living with HIV by policy makers, while simultaneously increasing public awareness to reduce the social stigma.

Psychological, social, and familial problems of people living with HIV/AIDS in Iran: A qualitative study

International Journal of Preventive Medicine, 2015

Background: HIV/AIDS is one of the diseases which not only makes threats to physical health, but also, due to the negative attitudes of people and the social stigma, affects the emotional and social health of patients. The aim of this study was to identify the psychological, social, and family problems of people living with HIV/AIDS (PLWHA) in Iran. Methods: In this qualitative study, we used purposive sampling to enroll PLWHA, their families, and physicians and consultants in two cities of Kermanshah and Tehran. Each group of PLWHA, their families, physicians, and consultants participated in two focus group discussions (FGDs), and a total of eight FGDs were conducted. Six interviews were held with all key people, individually. Results: Based on the views and opinions of various groups involved in the study, the main problems of PLWHA were: Ostracism, depression, anxiety, a tendency to get revenge and lack of fear to infect others, frustration, social isolation, relationship problems, and fear due to the social stigma. Their psychological problems included: Marriage problems, family conflict, lack of family support, economic hardships inhibiting marriage, and social rejection of patient's families. Their family problems were: Unemployment, the need for housing, basic needs, homelessness, and lack of social support associations. Conclusions: It seems that the identification and focusing on psychological, social, and family problems of affected people not only is an important factor for disease prevention and control, but also enables patients to have a better response to complications caused by HIV/AIDS.

Barriers and facilitators of access to HIV prevention, care, and treatment services among people living with HIV in Kerman, Iran: a qualitative study

BMC Health Services Research

Background Low access to HIV prevention, care, and treatment services among people living with HIV (PLWH) is a barrier to the control of the epidemic worldwide. The present study aimed to assess the barriers and facilitators to HIV services among PLWH in Kerman, Iran. Methods In this qualitative study, a convenience sample of 25 PLWH who had received HIV prevention, treatment, or care services, and six PLWH who had not yet received services were recruited between August-October 2020. Data were collected using a semi-structured, face-to-face interview. Data were examined by inductive content analysis using MAXQDA 10 software. Results Nine categories of facilitators and 11 categories of barriers to HIV services were identified. Facilitating factors included: maintaining health status, feeling scared, trust in the health system, how they were treated by service providers, provision of suitable hours by the service provider center, changing attitudes towards HIV in society, acceptance o...

Sexual and Reproductive Health Needs of HIV-Positive People in Tehran, Iran: A Mixed-Method Descriptive Study

2015

Background People Living with HIV (PLHIV) are highly stigmatized and consequently hard-to-access by researchers and importantly, public health outreach in Iran, possibly due to the existing socio-cultural situation in this country. The present study aimed to evaluate the sexual and reproductive health needs of PLHIV in Tehran, the capital of Iran. Methods As a mixed-method descriptive study, this project was conducted in 2012 in Tehran, Iran. In this study, we evaluated and discussed socio-demographic characteristics, family and social support, sexual behaviors, fertility desires and needs, PMTCT services, contraceptive methods, unintended pregnancy and safe abortion, and Pap smear tests among 400 participants referring to the behavioral disorders consulting centers. Results Of the sample 240 (60%) were male and 160 (40%) were female. About 50% of women and 40% of men were 25-34 years old. More than 60% of men and 96% of women were married, while more than 50% of the participants had HIV-positive spouses at the time of study. According to the results, fertility desire was observed among more than 30% of female and 40% of male participants. Results of the in-depth interviews indicate that the participants are not satisfied with most of the existing services offered to address their sexual and reproductive health needs. Conclusion Despite the availability of services, most of sexual and reproductive health needs of the PLHIV are overlooked by the health system in Iran. Paying attention to sexual and reproductive health needs of PLHIV in Iran not only protects their right to live long and healthy lives, but also may prevent the transmission of HIV from the patients to others within the community.

An analytic approach to HIV testing and counseling services in Iran

Journal of HIV/AIDS & Social Services, 2018

Generally, two levels of services are defined to manage HIV/AIDS epidemic, comprising HIV testing and counseling (HTC) services. In this letter our emphasis is on HTC services in line with achieving the first goal of 90-90-90 UNAIDS' program which is 90% of all infected people with HIV should know their status. Iran developed a comprehensive harm reduction program through establishing Voluntary Counseling and Testing services (VCT) within "triangular clinics." As a result, it witnessed an increase in access to HTC both for injection drug users (IDUs) and individuals with sexual transmission risks. However, Iran has been facing two major obstacles including a remarkable gap between the estimated (75,700) and identified (28,663) number of HIVinfected individuals and a change in HIV transmission route from the second to the third wave that is sexual contact. To combat these weaknesses three strategies should be considered: (a) integrating HTC programs to primary care package, (b) training and motivating healthcare providers in pre and post-test counseling, and (c) attracting participation of private sector.

The impact of the COVID-19 pandemic on the provision of HIV/AIDS-related services in Iran: a qualitative study

BMC Health Services Research

Background Providing services to people living with HIV (PLWH) faced many challenges during the COVID-19 pandemic. This study aimed to examine the impact of the COVID-19 pandemic on providing HIV/AIDS-related services in Iran. Methods In this qualitative study, the participants were included by purposive sampling between November 2021 and February 2022. Virtually focused group discussion (FGD) meetings were conducted with the first group including policymakers, service providers, and researchers (n = 17), and the interviews were conducted telephonic and face-to-face using a semi-structured guide with the second group including people who received services (n = 38). Data were analyzed by content analysis using the inductive method in MAXQDA 10 software. Results Six categories were obtained, including mostly affected services, ways of the effect of COVID-19, healthcare systems reaction, effects on social inequality, opportunities created by the pandemic, and suggestions for the future...

HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran

The Open AIDS Journal

Introduction: Most of the studies on HIV/AIDS health care status are usually conducted in big cities while small towns and rural areas are faced with specific challenges. This study aimed to identify the barriers and problems encountered by HIV-positive patients when receiving health services in the small cities and rural areas of Iran. Methodology: This is a qualitative study that was conducted using an interpretive phenomenology method in 2016. This study was conducted through a semi-structured interview for which a purposeful sampling method was used. In the present study, data saturation was observed after 15 interviews, but more than 17 interviews were conducted to ensure the reliability of the interview. Data were analyzed by Colaizzi's method using MAXQDA10 software. Findings: Barriers and problems encountered by patients when receiving health care services consisted of 10 categories, 32 main themes and 67 sub-themes. The categories were as follows: fear of revealing the ...

Counseling and Harm Reduction Centers for Vulnerable Women to HIV/AIDS in Iran

Iranian journal of public health, 2013

Human immunodeficiency virus (HIV) is a public health challenge facing both developing and developed nations. Although injecting drug use is even the main route of HIV transmission in Iran, sexual route is rising gradually. Vulnerable women have been considered as important bridging population for driving HIV epidemics. To increase the access to vulnerable women, in 2007, 5 pilot centers were established in risky areas to deliver comprehensive services to women who themselves or their spouses are engaged in drug use, risky sexual behavior or have history of imprisonment. Management of Sexually Transmitted Infection, psychological counseling and harm reduction are provided by female staff. The aim of this study was to report the activities conducting in 2008. Registered information was used to assess the demographic characteristic, HIV/ AIDS related risk factors and services delivered to clients. Till March 2008, 442 clients have been admitted. Most of them (36.2%) had 25-34 years ol...