HIV Positive Patients' Experience of Receiving Health Care Services: A Phenomenology Study in Iran (original) (raw)
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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.
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...
HIV/AIDS-related stigma can affect the diagnosis, treatment and the prevalence of HIV. Health providers’ stigmacan be fatal in this regard. In this study,we have tried to explore the perceptions of health providers’ stigma against HIV/AIDS among HIV-affected women. Here we applied a phenomenography approach. Samples were selected purposively from the behavioural disorders clinic and HIV positive club of Iranian Research Centre for HIV/AIDS (HPC). In-depth interviews were conducted for at least one hour with 14 healthcare providers (HCP), 14 women living with HIV and 7 family members. Data collections and analysis were conducted at the same time using a seven-step Sjöström process. Women experienced health providers’ stigma in two contexts: i- Professional Level (ethics, relations and duties); ii- Institutional Level (support, education/research, monitoring and services). Wefound lack of communication skills and professional ethics. To remove stigma, we need to evaluate, modify and design various organisational programs with its relevant applications .
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.
Heliyon
Background: A diagnosis of HIV (human immunodeficiency virus) infection causes a wide range of mental challenges regarding the meaning and understanding of such a diagnosis because of the specific nature of HIV and its social consequences. AIDS patients perceived their disease as multidimensional Stigma and rejection and even discrimination and insult in receiving health services. Therefore, a deep awareness and understanding of an individual's meaning and interpretation of a HIV-positive diagnosis and their relevant experiences are essential for providing better care. Objective: This study aimed to examine the attitude, understanding, and interpretation of a positive diagnosis of HIV. Methods: The present qualitative study was based on the descriptive phenomenological method. Participants included 13 HIV-positive patients who had been referred to the Kermanshah Counseling Center for Behavioral Diseases in Iran and diagnosed at most 6 months before being interviewed. The data were collected via semistructured in-depth interviews. Results: The continuous analyses of the data and the interview notes resulted in the identification of five main themes: contagious disease with two subthemes Illness and Harm to others, new self with a Crisis of identity subtheme, disappointment with the life ending and impending death subtheme, unmentionable disease with two subthemes secretive and horrifying diseases, and loss with Frustration subtheme. Conclusion: Because the attitudes and behaviors of other people, such as relatives and people in society had a negative impact on the participants' mental status, as well as on their perceptions and understanding about the positive diagnosis, the focus of care for people with HIV/AIDS should shift from therapeutic issues to sociocultural ones. These issues play a major role in forming an individual's understanding of HIV and can be a vital factor in improving their activities and adaptations to a positive diagnosis.
Rejection, Current Suffering in the Lives of People With HIV/AIDS: A Qualitative Study in Iran
Caspian Journal of Health Research (CJHR), 2024
People with HIV/AIDS face numerous challenges, including the effect of the disease on their personal relationships with family, friends, colleagues, and healthcare professionals. Objectives: The purpose of this qualitative study was to investigate social interactions among patients with HIV/AIDS in Iran. Materials & Methods: This qualitative content analysis study was conducted on 12 patients with HIV/AIDS referring to the Behavioral Disease Counseling Center of Imam Khomeini Hospital in Tehran and the Behavioral Disease Counseling Center in Rasht City in 2018. Semi-structured, face-to-face, and audio-recorded interviews were used to collect data. Purposive sampling with maximum variation was used to select participants. The duration of the interview was between 40 to 75 min. MAXQDA software, version 10 was used for data organization and management, and conventional content analysis was used for data analysis. Results: From the analysis of interviews with 12 individuals with HIV/AIDS (7 men and 5 women), 51 codes were extracted in three categories: Disease disclosure (disclosure to important people in life, disclosure to public and health services, and dealing with the challenges of disclosure), social support (impairment in interpersonal relationships and relationships with peers), and acceptance (social acceptance and acceptance by health care providers). Conclusion: Despite significant progress in HIV/AIDS prevention, treatment, and education, the stigma caused by this disease remains high and has a negative impact on the interpersonal relationships of people living with HIV/AIDS with their families, relatives, friends, colleagues, and healthcare providers.
Eastern Mediterranean Health Journal, 2019
Background: People living with HIV can have many health problems and may face difficulties when seeking health care because of stigma and the inappropriate behaviour of health care staff. Aims: This study aimed to assess the problems people living with HIV face when seeking health care in the Islamic Republic of Iran. Methods: A qualitative study was conducted with 10 people living with HIV who were members of the positive fellowship club of the Imam Khomeini Hospital in Tehran, Islamic Republic of Iran. Participation was voluntary. Using a focus group discussion, the participants talked about the problems they faced when seeking health care in different health departments and clinics. Data were analysed using inductive content analysis. Results: The participants faced many problems in all health departments and clinics when seeking health care. The most important problems were: 1) refusal of treatment in outpatient, medical and surgical departments; 2) inappropriate behaviour of consultants and medical staff; and 3) insufficient knowledge of medical staff about HIV and how it is transmitted. Conclusions: Providing medical and health care staff with more information on HIV and its transmission, training them on proper treatment and management of patients with HIV, and providing free treatment packages and medical services for people living with HIV may help reduce the stigma and problems HIV patients face when seeking health care, and improve the care they receive.
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...
Barriers to self-care in women of reproductive age with HIV/AIDS in Iran: a qualitative study
The Pan African medical journal, 2017
Although increasing attention is paid to HIV/AIDS, patients with HIV still experience several barriers to self-care. These barriers have been previously identified in small quantitative studies on women with HIV, but qualitative studies are required to clarify barriers to self-care. We conducted our study using the grounded theory methodological approach. A total of 28 women with HIV and their family members, were interviewed. The data were analyzed with the Corbin and Strauss method (1998). The key barriers to self-care in women with HIV/AIDS included social stigma, addiction, psychological problems, medication side-effects and financial problems. Women with HIV/AIDS face several barriers to self-care. Therefore, when designing self-care models for these women, social and financial barriers should be identified. Mental health treatment should also be incorporated into such models and patients' access to health care services should be facilitated.