How informal healthcare providers improve uptake of HIV testing: qualitative results from a randomized controlled trial
| Autor: | Matthew Ponticiello, Juliet Mwanga-Amumpaire, Patricia Tushemereirwe, Gabriel Nuwagaba, Denis Nansera, Rachel King, Winnie Muyindike, Radhika Sundararajan |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Counseling Male Rural Population Pediatric AIDS Adolescent Health Personnel Clinical Trials and Supportive Activities Immunology HIV Infections Medical and Health Sciences Article Clinical Research Virology Behavioral and Social Science Humans Immunology and Allergy Uganda Pediatric Prevention Psychology and Cognitive Sciences HIV Health Services Biological Sciences community-based intervention traditional healers Good Health and Well Being Infectious Diseases qualitative HIV/AIDS Female Infection |
| Zdroj: | AIDS AIDS (London, England), vol 36, iss 8 |
| ISSN: | 1473-5571 0269-9370 |
| DOI: | 10.1097/qad.0000000000003227 |
| Popis: | ObjectiveUganda is HIV-endemic with a prevalence of 5.7%. Lack of epidemic control has been attributed to low engagement with HIV testing. Collaborating with informal healthcare providers, such as traditional healers, has been proposed as a strategy to increase testing uptake. We explored acceptability and implementation of an HIV testing program where traditional healers delivered point-of-care testing and counseling to adults of unknown serostatus (clinicaltrials.gov NCT#03718871).MethodsThis study was conducted in rural, southwestern Uganda. We interviewed participating traditional healers ( N = 17) and a purposive sample of trial participants ( N = 107). Healers were practicing within 10 km of Mbarara township, and 18+ years old. Participants were 18+ years old; sexually active; had received care from participating healers; self-reported not receiving an HIV test in prior 12 months; and not previously diagnosed with HIV infection. Interviews explored perceptions of a healer-delivered HIV testing model and were analyzed following a content-analysis approach.ResultsMost participants were female individuals ( N = 68, 55%). Healer-delivered HIV testing overcame structural barriers, such as underlying poverty and rural locations that limited use, as transportation was costly and often prohibitive. Additionally, healers were located in villages and communities, which made services more accessible compared with facility-based testing. Participants also considered healers trustworthy and 'confidential'. These qualities explain some preference for healer-delivered HIV testing, in contrast to 'stigmatizing' biomedical settings.ConclusionTraditional healer-delivered HIV testing was considered more confidential and easily accessible compared with clinic-based testing. Offering services through traditional healers may improve uptake of HIV testing services in rural, medically pluralistic communities. |
| Databáze: | OpenAIRE |
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