Community Preparedness, Acceptability, and Uptake of UTT Services in PHC Facilities

Dzunisani B. Mhlari, Mathildah M. Mokgatle, Ntlogeleng M. Mogale, Raikane J. Seretlo

Abstract


Background: The Universal Test and Treat (UTT) strategy ensures that people test and initiate early treatment in health facilities. Communities have benefited from this strategy to help manage HIV and prevent the spread of the disease, but the way people perceive the strategy and their experiences of testing and initiating antiretroviral therapy (ART) on the same day have an impact on their remaining on treatment and on their adherence. The aim of the study: The aim of this study was to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. Method: This is a qualitative study that used in-depth interviews to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. The twenty-seven participants were purposefully selected from three health facilities in the sub-district. The data were collected and transcribed verbatim. The transcripts were analyzed using thematic content analysis. Results: The participants reported that they were not knowledgeable about or aware of the strategy until they tested positive in their clinics. HIV testing services (HTS) are still underused, as the participants presented to the facilities only when they were seriously ill, had various symptoms, or were pregnant. They described accepting their status and treatment because they were already sick, and there was nothing that they could do but take treatment. Despite the different emotions they experienced, the participants were able to accept their treatment and their status. Surprisingly, those who were still in denial also accepted treatment. Some were able to disclose and received support from their family, partners, and friends, but others had not disclosed. The data also showed their fear of stigmatization if they were seen coming to the clinic frequently. Conclusion: Being diagnosed with the human immunodeficiency virus (HIV) is still a source of embarrassment. There is still a need to educate communities about the virus, encourage them to use HTS, and empower them with information to minimize stigma and promote social support.

 

Doi: 10.28991/SciMedJ-2023-05-02-02

Full Text: PDF


Keywords


Community; Preparedness; Acceptability; Uptake; UTT & Primary HEALTH CARE (PHC) Facilities.

References


Bantie, B., Yirga, G. K., Abate, M. W., Amare, A. T., Nigat, A. B., Tigabu, A., Kerebeh, G., Emiru, T. D., Tibebu, N. S., Tiruneh, C. M., Misganaw, N. M., Temesgen, D., Bizuayehu, M. A., Nuru, A., Hiruy, E. G., & Kassaw, A. (2022). Delayed ART initiation in “Test and Treat era” and its associated factors among adults receiving antiretroviral therapy at public health institutions in Northwest Ethiopia: A multicenter cross-sectional study. PLoS ONE, 17(7 July), 271127. doi:10.1371/journal.pone.0271127.

Ford, N., Migone, C., Calmy, A., Kerschberger, B., Kanters, S., Nsanzimana, S., Mills, E. J., Meintjes, G., Vitoria, M., Doherty, M., & Shubber, Z. (2018). Benefits and risks of rapid initiation of antiretroviral therapy. Aids, 32(1), 17–23. doi:10.1097/QAD.0000000000001671.

Dlamini, N., Ntuli, B., & Madiba, S. (2021). Perceptions and Experiences of Participating in PMTCT Option B Plus: An Explorative Study on HIV-positive Pregnant Women in Eswatini. The Open Public Health Journal, 14(1), 425–434. doi:10.2174/1874944502114010425.

El-Sadr, W. M., & Goosby, E. (2018). Building on the HIV platform: Tackling the challenge of noncommunicable diseases among persons living with HIV. Aids, 32, S1–S3. doi:10.1097/QAD.0000000000001886.

Lujintanon, S., Amatavete, S., Leenasirimakul, P., Meechure, J., Noopetch, P., Sangtong, S., Sittikarn, S., Phoopisutthisak, P., Seekaew, P., Mills, S., Phanuphak, P., Ramautarsing, R. A., & Phanuphak, N. (2023). Acceptability and retention of the key population-led HIV treatment service for men who have sex with men and transgender women living with HIV in Thailand. Journal of the International AIDS Society, 26(2), 26062. doi:10.1002/jia2.26062.

Beyrer, C. (2021). A pandemic anniversary: 40 years of HIV/AIDS. The Lancet, 397(10290), 2142–2143. doi:10.1016/S0140-6736(21)01167-3.

Nhassengo, P., Cataldo, F., Magaço, A., Hoffman, R. M., Nerua, L., Saide, M., Cuco, R., Hoek, R., Mbofana, F., Couto, A., Gudo, E., Chicumbe, S., & Dovel, K. (2018). Barriers and facilitators to the uptake of Test and Treat in Mozambique: A qualitative study on patient and provider perceptions. PLoS ONE, 13(12), 205919. doi:10.1371/journal.pone.0205919.

Ahmed, I., Demissie, M., Worku, A., Gugsa, S., & Berhane, Y. (2020). Effectiveness of same-day antiretroviral therapy initiation in retention outcomes among people living with human immunodeficiency virus in Ethiopia: empirical evidence. BMC Public Health, 20(1). doi:10.1186/s12889-020-09887-9.

Chauke, P., Huma, M., & Madiba, S. (2020). Lost to follow up rate in the first year of art in adults initiated in a universal test and treat programme: A retrospective cohort study in Ekurhuleni district, South Africa. Pan African Medical Journal, 37, 1–13. doi:10.11604/pamj.2020.37.198.25294.

Onoya, D., Hendrickson, C., Sineke, T., Maskew, M., Long, L., Bor, J., & Fox, M. P. (2021). Attrition in HIV care following HIV diagnosis: a comparison of the pre-UTT and UTT eras in South Africa. Journal of the International AIDS Society, 24(2), 25652. doi:10.1002/jia2.25652.

Green, D., Tordoff, D. M., Kharono, B., Akullian, A., Bershteyn, A., Morrison, M., Garnett, G., Duerr, A., & Drain, P. K. (2020). Evidence of sociodemographic heterogeneity across the HIV treatment cascade and progress towards 90-90-90 in sub-Saharan Africa – a systematic review and meta-analysis. Journal of the International AIDS Society, 23(3), 25470. doi:10.1002/jia2.25470.

Maluleka, L. M., Hlongwane, N., & Mokgatle, M. M. (2023). Knowledge and Perceptions of Healthcare Workers about the Implementation of the Universal Test and Treat Guideline in Under-Resourced, High-HIV Prevalence Rural Settings. Healthcare (Switzerland), 11(7), 968. doi:10.3390/healthcare11070968.

Kimanga, D. O., Oramisi, V. A., Hassan, A. S., Mugambi, M. K., Miruka, F. O., Muthoka, K. J., Odhiambo, J. O., Yegon, P. K., Omoro, G. O., Mbaire, C., Masamaro, K. M., Njogo, S. M., Barker, J. L., & Ngugi, C. N. (2022). Uptake and effect of universal test-and-treat on twelve months retention and initial virologic suppression in routine HIV program in Kenya. PLoS ONE, 17(11 November), 277675. doi:10.1371/journal.pone.0277675.

Girum, T., Yasin, F., Wasie, A., Shumbej, T., Bekele, F., & Zeleke, B. (2020). The effect of “universal test and treat” program on HIV treatment outcomes and patient survival among a cohort of adults taking antiretroviral treatment (ART) in low income settings of Gurage zone, South Ethiopia. AIDS Research and Therapy, 17(1), 1–9. doi:10.1186/s12981-020-00274-3.

Dawit, Z., Sahile, S., Getaneh, Y., Samuel, H., Bojola, F., Hailu, M., & Dishole, D. (2021). Incidence and predictors of mortality among adults ART users on universal test and treat approach in a public health facility, South Ethiopia 2021. Research Square. doi:10.21203/rs.3.rs-2104715/v1.

Mugenyi, L., Nanfuka, M., Byawaka, J., Agaba, C., Mijumbi, A., Kagimu, D., Mugisha, K., Shabbar, J., & Etukoit, M. (2022). Effect of universal test and treat on retention and mortality among people living with HIV-infection in Uganda: An interrupted time series analysis. PLoS ONE, 17(5 May), 268226. doi:10.1371/journal.pone.0268226.

Ross, J., Ingabire, C., Umwiza, F., Gasana, J., Munyaneza, A., Murenzi, G., Nsanzimana, S., Remera, E., Akiyama, M. J., Anastos, K. M., & Adedimeji, A. (2021). How early is too early? Challenges in ART initiation and engaging in HIV care under Treat All in Rwanda-A qualitative study. PLoS ONE, 16(5 May), 251645. doi:10.1371/journal.pone.0251645.

Moges, N. A., Adesina, O. A., Okunlola, M. A., & Berhane, Y. (2020). Barriers and facilitators of same-day antiretroviral therapy initiation among people newly diagnosed with HIV in Ethiopia: Qualitative study using the transtheoretical model of behavioral change. Journal of Multidisciplinary Healthcare, 13, 1801–1815. doi:10.2147/JMDH.S282116.

Adams, C., Kiruki, M., Karuga, R., Otiso, L., Graham, S. M., & Beima-Sofie, K. M. (2022). “Your status cannot hinder you”: the importance of resilience among adolescents engaged in HIV care in Kenya. BMC Public Health, 22(1). doi:10.1186/s12889-022-13677-w.

Lilian, R. R., Rees, K., McIntyre, J. A., Struthers, H. E., & Peters, R. P. H. (2020). Same-day antiretroviral therapy initiation for HIV-infected adults in South Africa: Analysis of routine data. PLoS ONE, 15(1), 227572. doi:10.1371/journal.pone.0227572.

Govere, S. M., Galagan, S., Tlou, B., Mashamba-Thompson, T., Bassett, I. V., & Drain, P. K. (2021). Effect of perceived HIV risk on initiation of antiretroviral therapy during the universal test and treat era in South Africa. BMC Infectious Diseases, 21(1), 1–7. doi:10.1186/s12879-021-06689-1.

Bukhori, B., Hidayanti, E., & Situmorang, D. D. B. (2022). Religious coping strategies for people with HIV/AIDS (PLWHA) Muslims in Indonesia: A qualitative study with a telling-the-stories. Heliyon, 8(12), 12208. doi:10.1016/j.heliyon.2022.e12208.

Grill, K. B., Wang, J., Cheng, Y. I., & Lyon, M. E. (2020). The role of religiousness and spirituality in health-related quality of life of persons living with HIV: A latent class analysis. Psychology of Religion and Spirituality, 12(4), 494–504. doi:10.1037/rel0000301.

Pascoe, S. J. S., Scott, N. A., Fong, R. M., Murphy, J., Huber, A. N., Moolla, A., Phokojoe, M., Gorgens, M., Rosen, S., Wilson, D., Pillay, Y., Fox, M. P., & Fraser-Hurt, N. (2020). “Patients are not the same, so we cannot treat them the same” – A qualitative content analysis of provider, patient and implementer perspectives on differentiated service delivery models for HIV treatment in South Africa. Journal of the International AIDS Society, 23(6), 25544. doi:10.1002/jia2.25544.

Garrett, N., Norman, E., Leask, K., Naicker, N., Asari, V., Majola, N., Karim, Q. A., & Karim, S. S. A. (2018). Acceptability of Early Antiretroviral Therapy among South African Women. AIDS and Behavior, 22(3), 1018–1024. doi:10.1007/s10461-017-1729-2.

Onoya, D., Mokhele, I., Sineke, T., Mngoma, B., Moolla, A., Vujovic, M., Bor, J., Langa, J., & Fox, M. P. (2021). Health provider perspectives on the implementation of the same-day-ART initiation policy in the Gauteng province of South Africa. Health Research Policy and Systems, 19(1), 1–12. doi:10.1186/s12961-020-00673-y.


Full Text: PDF

DOI: 10.28991/SciMedJ-2023-05-02-02

Refbacks

  • There are currently no refbacks.


Copyright (c) 2023 Dzunisani Babra Mhlari, Mathildah Mpata Mokgatle, Ntlogeleng Mabina Mogale, Raikane James Seretlo