Patient-provider perceptions on engagement in HIV care in Argentina

Lina Margarita Bofill, Maria Lopez, Analia Dorigo, Alejandra Bordato, Mar Lucas, Graciela Fernandez Cabanillas, Omar Sued, Pedro Cahn, Isabel Cassetti, Stephen Weiss, Deborah Jones

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Approximately 30% of patients participating in the national antiretroviral therapy (ART) program in Argentina fail to achieve an undetectable viral load, and approximately 25% are not retained in care. This qualitative study was designed to explore and identify factors associated with engagement and retention in public and private health care in Buenos Aires, Argentina. Qualitative data from key informants (n = 12) and focus groups (n = 4 groups) of patients and providers from private and public HIV treatment facilities were recorded and transcribed. Predetermined and arising themes related to adherence, engagement, and retention in care were coded and analyzed using qualitative data analysis software. Reasons identified for patients' lack of adherence or engagement in care differed between patients and providers, and patients attributed limitations to low self-efficacy, fear and concerns about HIV, and lack of provider involvement in treatment. In contrast, providers viewed themselves as decision-makers in patient care and patients as responsible for their own nonadherence due to lack of commitment to their own health or due to medication side effects. Patients reported health care system limitations and HIV concerns contributed to a lack of engagement, and providers identified limited HIV literacy and stigma as additional problems. Both agreed that chronic illness and substance addiction impacted adherence and retention, and agreed on the importance of trust, honesty, and communication in the patient-provider relationship. Results support the incorporation of system-, provider-, and patient-focused components into interventions to facilitate patient engagement, adherence, and retention in public and private settings in Argentina.

Original languageEnglish (US)
Pages (from-to)602-607
Number of pages6
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume26
Issue number5
DOIs
StatePublished - May 4 2014

Keywords

  • adherence
  • Argentina
  • communication
  • engagement
  • HIV

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Social Psychology

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  • Cite this

    Bofill, L. M., Lopez, M., Dorigo, A., Bordato, A., Lucas, M., Cabanillas, G. F., Sued, O., Cahn, P., Cassetti, I., Weiss, S., & Jones, D. (2014). Patient-provider perceptions on engagement in HIV care in Argentina. AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 26(5), 602-607. https://doi.org/10.1080/09540121.2013.844767