Factors associated with delay in seeking antiretroviral therapy in Zimbabwe : cross-sectional study

Makurumidze, Richard (2013-03)

Thesis (MPhil)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: Access to antiretroviral therapy has been gradually increasing in resource limited settings, Zimbabwe included. Despite the increasing access to antiretroviral therapy quite a number of patients are still delaying to seek antiretroviral therapy. The purpose of the study was to examine factors associated with delay in seeking antiretroviral therapy. A survey was conducted at Parirenyatwa Hospital Opportunistic Infections/Antiretroviral Therapy Clinic from September and November 2012. A total of 80 participants starting antiretroviral therapy who met the criteria were included in the study. The inclusion criteria included patients 18 years above but less than 65 years, no prior history of antiretroviral therapy and eligibility for antiretroviral therapy based on CD4 count or World Health Organisation clinical staging. An interviewer administered questionnaire containing demographic, socio-economic and health-facility factors were used to collect data. Four weeks was used as a cut off point for delay in seeking antiretroviral therapy. The majority of participants (60%) delayed seeking antiretroviral therapy and the factors which were associated with delay in seeking antiretroviral therapy included female gender; lack of a partner; low level of education; low socio-economic status; treatment of opportunistic infections; extra laboratory tests on top of the CD4 count tests; not being on Cotrimoxazole Prophylaxis; not being referred for antiretroviral therapy by the testing site; stigma and discrimination. However disclosure was not associated with early seeking of antiretroviral therapy. Health system factors such as attitude of health care workers, shortage of staff and long waiting times were also identified as bottlenecks to patients seeking antiretroviral therapy early. Efforts to increase early starting of antiretroviral therapy should focus on addressing the referral system from testing sites to antiretroviral therapy initiating sites, improving efficiency of antiretroviral initiating sites, increasing point of care HIV & AIDS diagnostics tools and addressing patient‟s concerns such as stigma & discrimination.

AFRIKAANSE OPSOMMING: Toegang tot antiretrovirale terapie Geleidelik is steeds in hulpbron beperkte omgewing, Zimbabwe ingesluit. Ten spyte van die toenemende toegang tot antiretrovirale terapie 'n hele aantal van die pasiënte is nog steeds vertraag antiretrovirale terapie te soek. Die doel van die studie was om faktore te ondersoek wat verband hou met vertraging in die soek van antiretrovirale terapie. 'n Opname is by Parirenyatwa-hospitaal opportunistiese infeksies / antiretrovirale terapie Clinic van September en November 2012. 'N totaal van 80 deelnemers begin antiretrovirale terapie wat met die kriteria wat in die studie ingesluit is. Die insluiting kriterium was pasiënte ouer as 18 jaar maar minder as 65 jaar, geen geskiedenis voor antiretrovirale terapie en in aanmerking kom vir antiretrovirale terapie gebaseer op CD4-telling of Kliniese stadiëring Wêreld Gesondheid Organisasie. Was 'n onderhoudvoerder vraelys met demografiese, sosio-ekonomiese faktore en gesondheid-fasiliteit wat gebruik word om data in te samel. 4 weke is gebruik as die afsny punt vir die vertraging in die soeke na antiretrovirale terapie. Die meerderheid van die deelnemers (60%) antiretrovirale terapie en die faktore wat verband hou met die vertraging in die soek na antiretrovirale terapie is vertraag te soek vroulike geslag, gebrek van 'n vennoot, lae vlak van onderwys, 'n lae sosio-ekonomiese status, behandeling van opportunistiese infeksies; Ekstra laboratoriumtoetse op die top van die CD4-telling toetse nie op Cotrimoxazole Profilakse, nie vir antiretrovirale terapie verwys deur die toets site, stigma en diskriminasie. Egter openbaarmaking wat nie verband hou met die vroeë soek van antiretrovirale terapie. Gesondheid stelsel faktore soos houding van gesondheidsorgwerkers, tekort aan personeel en lang wagtye, is ook geïdentifiseer as knelpunte aan pasiënte op soek na vroeë antiretrovirale terapie Pogings om te vroeg begin van antiretrovirale terapie Verhoog Indien Fokus op die verwysingstelsel van die toets sites tot antiretrovirale terapie Inisiëring sites, verbetering van doeltreffendheid van antiretrovirale Inisiëring sites, Verhoog Punt van Care MIV & VIGS diagnose tools en aanspreek van die pasiënt se Kommer Soos stigma en diskriminasie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/79913
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