Original Research

Barriers to HIV service utilisation by people living with HIV in two provinces of Zimbabwe: Results from 2016 baseline assessment

Taurayi A. Tafuma, Nyikadzino Mahachi, Chengetai Dziwa, Tafara Moga, Paul Baloyi, Gladys Muyambo, Auxilia Muchedzi, Tinashe Chimbidzikai, Getrude Ncube, Joseph Murungu, Tendai Nyagura, Katherine Lew
Southern African Journal of HIV Medicine | Vol 19, No 1 | a721 | DOI: https://doi.org/10.4102/sajhivmed.v19i1.721 | © 2018 Taurayi A. Tafuma, Nyikadzino Mahachi, Chengetai Dziwa, Tafara Moga, Paul Baloyi, Gladys Muyambo, Auxilia Muchedzi, Tinashe Chimbidzikai, Getrude Ncube, Tendai Nyagura, Katherine Lew | This work is licensed under CC Attribution 4.0
Submitted: 13 January 2017 | Published: 09 August 2018

About the author(s)

Taurayi A. Tafuma, FHI 360, Zimbabwe
Nyikadzino Mahachi, FHI 360, Zimbabwe
Chengetai Dziwa, FHI 360, Zimbabwe
Tafara Moga, FHI 360, Zimbabwe
Paul Baloyi, FHI 360, Zimbabwe
Gladys Muyambo, Plan International, Zimbabwe
Auxilia Muchedzi, FHI 360, Zimbabwe
Tinashe Chimbidzikai, FHI 360, Zimbabwe
Getrude Ncube, Ministry of Health and Child Care, Zimbabwe
Joseph Murungu, Ministry of Health and Child Care, Zimbabwe
Tendai Nyagura, United States Agency for International Development, Zimbabwe
Katherine Lew, FHI 360, Zimbabwe


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Abstract

Background: The emergence of antiretroviral therapy (ART) transformed HIV from a terminal illness to a chronic disease. However, limited access to health services remains one of many barriers to HIV service utilisation by people living with HIV (PLHIV) in low-resource settings. The goal of this study was to describe the barriers to HIV service utilisation in two provinces of Zimbabwe.

Methods: A qualitative descriptive study was conducted with PLHIV and village health workers (VHW) in eight districts within the two provinces. Convenience sampling was used to select the participants. This sampling was limited to communities supported by health facilities with more than 500 PLHIV enrolled into HIV care and treatment. Interviews were audio-recorded and transcripts were subjected to thematic content analysis.

Results: A total of 22 community focus group discussions (FGDs) were conducted. Barriers to using HIV services cited in PLHIV and VHW FGDs were similar. These were categorised as health system-related barriers, which include user fees, long waiting times, lack of confidentiality and negative attitudes by healthcare providers, and lack of consistent community-based HIV services. Community-related barriers cited were stigma and discrimination, food insecurity, distance to facilities and counterproductive messaging from religious sectors. Client-related factors reported were inadequate male involvement in HIV-related activities and defaulting after symptoms improved.

Conclusion: Our assessment has indicated that there are several barriers to the utilisation of HIV services by PLHIV in the two provinces of Zimbabwe. As new strategies and programmes are being introduced in the current resource-constrained era, efforts should be made to understand the needs of the clients. If programmes are designed with an effort to address some of these challenges, there is a possibility that countries will quickly achieve the 90-90-90 targets set by The Joint United Nations Programme on HIV/AIDS.


Keywords

barriers; HIV services; community; PLHIV; utilisation; Zimbabwe

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