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Women living with HIV, diabetes and/or hypertension multimorbidity in Uganda: A qualitative exploration of experiences accessing a ‘one stop’ integrated care service.

Van Hout, MC, Zalwango, F, Akugizibwe, M, Namulundu Chaka, M, Bigland, C, Birungi, J, Jaffar, S, Bachmann, M and Murdoch, J (2022) Women living with HIV, diabetes and/or hypertension multimorbidity in Uganda: A qualitative exploration of experiences accessing a ‘one stop’ integrated care service. Journal of Integrated Care. ISSN 1476-9018

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Purpose: Women experience a triple burden of ill-health spanning non-communicable diseases (NCDs), reproductive and maternal health conditions and human immunodeficiency virus (HIV) in sub-Saharan Africa.. Whilst there is research on integrated service experiences of women living with HIV (WLHIV) and cancer, little is known regarding those of WLHIV, diabetes and/or hypertension when accessing integrated care. Design: The INTE-AFRICA project conducted a pragmatic parallel arm cluster randomised trial to scale up and evaluate ‘one-stop’ integrated care clinics for HIV-infection, diabetes and hypertension at selected primary care centres in Uganda. A qualitative process evaluation explored and documented patient experiences of integrated care for HIV, diabetes and/or hypertension. In-depth interviews were conducted using a phenomenological approach with six WLHIV with diabetes and/or hypertension accessing a ‘one stop’ clinic. Thematic analysis of narratives revealed five themes: lay health knowledge and alternative medicine; community stigma; experiences of integrated care; navigating personal challenges and health service constraints. Findings: WLHIV described patient pathways navigating HIV and diabetes/hypertension, with caregiving responsibilities, poverty, travel time and cost and personal ill health impacting on their ability to adhere to multi-morbid integrated treatment. Health service barriers to optimal integrated care included unreliable drug supply for diabetes/hypertension and HIV linked stigma. Comprehensive integrated care is recommended to further consider gender sensitive aspects of care. Originality: This study whilst small scale, provides a unique insight into the lived experience of WLHIV navigating care for HIV and diabetes and/or hypertension, and how a ‘one stop’ integrated care clinic can support them (and their children) in their treatment journeys.

Item Type: Article
Additional Information: This author accepted manuscript is deposited under a Creative Commons Attribution Non-commercial 4.0 International (CC BY-NC) licence. This means that anyone may distribute, adapt, and build upon the work for non-commercial purposes, subject to full attribution. If you wish to use this manuscript for commercial purposes, please contact permissions@emerald.com
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Public Health Institute
Publisher: Emerald
SWORD Depositor: A Symplectic
Date Deposited: 21 Oct 2022 08:47
Last Modified: 20 Dec 2022 11:45
DOI or ID number: 10.1108/JICA-06-2022-0033
URI: https://researchonline.ljmu.ac.uk/id/eprint/17913
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