Title | Shortening "the Road" to Improve Engagement with HIV Testing Resources: A Qualitative Study Among Stakeholders in Rural Uganda. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Broderick K, Ponticiello M, Nabukalu D, Tushemereirwe P, Nuwagaba G, King R, Mwanga-Amumpaire J, Sundararajan R |
Journal | AIDS Patient Care STDS |
Volume | 35 |
Issue | 2 |
Pagination | 56-62 |
Date Published | 2021 Feb |
ISSN | 1557-7449 |
Keywords | Adult, Aged, Female, HIV Infections, HIV Testing, Humans, Interviews as Topic, Male, Medicine, African Traditional, Middle Aged, Patient Acceptance of Health Care, Qualitative Research, Rural Population, Uganda |
Abstract | In HIV-endemic areas, traditional healers are frequently used with, or instead of, biomedical resources for health care needs. Studies show healers are interested in and capable of supporting patients in the HIV care cascade. However, adults who receive care from healers have low engagement with HIV services. To achieve epidemic control, we must understand gaps between the needs of HIV-endemic communities and the potential for healers to improve HIV service uptake. This study's objective was to characterize stakeholder perspectives on barriers to HIV testing and approaches to mitigate barriers in a medically pluralistic, HIV-endemic region. This study was conducted in Mbarara District, a rural area of southwestern Uganda with high HIV prevalence. Participants included HIV clinical staff, traditional healers, and adults receiving care from healers. Fifty-six participants [N = 30 females (52%), median age 40 years (interquartile range, 32-51.5)] were recruited across three stakeholder groups for minimally structured interviews. Themes were identified using an inductive, grounded theory approach and linked together to create a framework explaining stakeholder perspectives on HIV testing. Stakeholders described the "road" to HIV testing as time-consuming, expensive, and stigmatizing. All agreed healers could mitigate barriers by delivering HIV testing at their practices. Collaborations between biomedical and traditional providers were considered essential to a successful healer-delivered HIV testing program. This work describes a novel approach to "shorten the road" to HIV testing, suggesting that traditional healer-delivered HIV testing holds promise to expand uptake of testing among communities with limited access to existing programs. |
DOI | 10.1089/apc.2020.0235 |
Alternate Journal | AIDS Patient Care STDS |
PubMed ID | 33471578 |
PubMed Central ID | PMC7885900 |
Grant List | K23 MH111409 / MH / NIMH NIH HHS / United States P30 AI036214 / AI / NIAID NIH HHS / United States UL1 TR001442 / TR / NCATS NIH HHS / United States |