Barriers in providing tuberculosis services for people living with HIV and their overcoming

Abstract


Aim. To study the opinions of specialists in tuberculosis institutions on barriers and ways to improve the system fighting the spread of human immunodeficiency virus (HIV) and tuberculosis.

Methods. In the study questionnaires with open and closed questions were used among employees of tuberculosis facilities in four territories of the North-West Region of Russia (Saint-Petersburg, Leningrad, Arkhangelsk, and Kaliningrad oblasts) during six months in 2018. Total of 284 subjects were included. The questionnaire consisted of 19 structured questions. The respondents’ answers were compared interregionally and were analyzed integrally inside the blocks with the calculation of their ratios.

Results. According to the specialists’ opinion working in tuberculosis facilities, the main barriers to providing tuberculosis services for people living with HIV are low level of intersectoral interaction, migration, increase in the number of injecting drug users, lack of regional government support, inconsistency of regulation documents with the requirements of currant reality. As the main conditions for improvement of epidemic situation with association of HIV/tuberculosis, the respondents consider increasing administration of antiretroviral therapy to the patients with HIV, adequate treatment of tuberculosis in HIV-infection and raising awareness of HIV-infection and tuberculosis by the population.

Conclusion. To improve the existing system of fighting HIV/tuberculosis, strengthening the connection among the stakeholders may be possible, especially between tuberculosis facilities and detention centers giving the valuable access to antiretroviral therapy, chemoprophylaxis and tuberculosis treatment, including establishment of low-threshold centers, improved population awareness of tuberculosis and HIV-infection.


Z M Zagdyn

Saint-Petersburg Research Institute of Phthisiopulmonology

Author for correspondence.
Email: dinmetyan@mail.ru
Saint-Petersburg, Russia

  1. Vasil'eva I.A., Belilovskiy E.M., Borisov S.E. et al. Tuberculosis with concurrent HIV infection in the Russian Federation and the world. Tuberkulez i bolezni legkikh. 2017; 95 (9): 8–18. (In Russ.)
  2. Nechaeva O.B. Tuberculosis epidemic situation among HIV positive people in the Russian Federation. Tuberkulez i bolezni legkikh. 2017; 95 (3): 13–19. (In Russ.)
  3. Barriers to access to tuberculosis treatment through the eyes of patients living with HIV infection and tuberculosis in Russia. https://evanetwork.ru/.../Bareryi-v-dostupe-k-lecheniyu-tuberkuleza-glazami-patsiento (access date: 12.03.2019). (In Russ.)
  4. Zinatsa F., Engelbrecht M., van Rensburg A.J., Kigozi G. Voices from frontline: barriers and strategies to improve tuberculosis infection control in primary health care facilities in South Africa. BMC Health Serv. Res. 2018; 18 (1): 269. doi: 10.1186/s12913-018-3083-0.
  5. Samrith W., Rahman M., Harun-Or-Rashid M., Sakamoto J. Trends and barriers to HIV testing among tuberculosis patients in Prey Kabas operational district, Takeo province, Cambodia. Asia Pac. J. Pub. H. 2015; 27 (2): NP789–797. doi: 10.1177/1010539512445190.
  6. Yablonskiy P.K. Stakeholders’ satisfaction with healthcare organizations: measurement and analysis of based on inquiry conducted in St. Petersburg public hospitals in 2016–2017. Meditsinskiy al'yans. 2018; (3): 93–101. (In Russ.)

Views

Abstract - 25

PDF (Russian) - 37

PlumX


© 2019 Zagdyn Z.M.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.


Свидетельство о регистрации СМИ ЭЛ № ФС 77-75008 от 1 февраля 2019 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)