Department of Health Policy, Planning & Management, School of Public Health, University of Ghana, Accra, Ghana.
Department of Biological, Environmental, and Occupational Health, School of Public Health, University of Ghana, Accra, Ghana.
PLoS One. 2024 Oct 11;19(10):e0311994. doi: 10.1371/journal.pone.0311994. eCollection 2024.
The intersection of infectious diseases, such as HIV, with chronic conditions like hypertension and diabetes poses a significant challenge in global health. While advancements in antiretroviral therapy have transformed HIV into a manageable chronic condition, a growing number of individuals with HIV now grapple with coexisting non-communicable diseases, impacting their Health-Related Quality of Life (HRQoL). Despite strides in HIV care, there is a notable policy gap that undermines efforts to address HIV-associated co-morbidities, particularly hypertension and diabetes, especially efforts to improve access, early detection, and ultimately HRQoL for individuals with HIV and co-morbidities. This study seeks to explore policy interventions aimed at improving the quality of life of HIV patients with hypertension or diabetes.
The study utilized a qualitative descriptive design to explore the experiences and perspectives of healthcare professionals and support staff regarding policy interventions for managing HIV patients with hypertension and/or diabetes co-morbidities in three regions of Ghana. The research was conducted in the Upper West, Ashanti, and Greater Accra regions among 11 participants, chosen purposively from professions involved in HIV patient care to understand their views on the implementation of policy interventions to HRQoL for individuals with HIV and co-morbidities. In-depth interviews were conducted face-to-face and tape-recorded. Thematic analysis approach was used to analyze the data.
The study involved 11 participants from three regions with varied years of experience. Implemented policies that potentially improve the HRQoL for individuals with HIV and co-morbidities involve support groups, home visits, provision of free drugs, and counselling. Barriers to policy implementation included non-adherence to medication, stigma, cost of non-communicable diseases (NCDs) medications, accessibility issues to NCDs services, lack of interest or understanding among implementers, and high staff turnover. Facilitators encompassed in-service training, guidelines in common platforms, knowledge sharing, external resources, regular check-ups, and motivational packages for patients.
Individuals with HIV and comorbidities face complex challenges impacting their HRQoL, including emotional and financial dimensions. The study identifies critical policies and barriers, underscoring the need for tailored, patient-centered approaches. Facilitators like in-service training and regular check-ups offer actionable insights for effective policy implementation, emphasizing improved health outcomes for those with comorbid conditions. The study recommends integrated care approach and adherence support programs that address the unique challenges faced by people living with HIV.
传染病(如 HIV)与高血压和糖尿病等慢性疾病的交叉,给全球健康带来了重大挑战。尽管抗逆转录病毒疗法的进步已经将 HIV 转变为一种可管理的慢性疾病,但越来越多的 HIV 感染者现在面临着共存的非传染性疾病,影响了他们的健康相关生活质量(HRQoL)。尽管在 HIV 护理方面取得了进展,但在解决 HIV 相关合并症(尤其是高血压和糖尿病)方面,仍存在明显的政策差距,这削弱了努力提高 HIV 感染者和合并症患者获得护理、早期发现和最终 HRQoL 的努力。本研究旨在探讨旨在改善高血压或糖尿病合并 HIV 患者生活质量的政策干预措施。
本研究采用定性描述设计,探讨了加纳三个地区(上西部、阿散蒂和大阿克拉地区)的医疗保健专业人员和支持人员对管理 HIV 合并高血压和/或糖尿病患者的政策干预措施的经验和观点。在这些地区,通过目的性选择参与 HIV 患者护理的专业人员,共有 11 名参与者参与了研究,以了解他们对实施改善 HIV 感染者和合并症患者 HRQoL 的政策干预措施的看法。面对面进行了深入访谈并进行了录音。使用主题分析方法对数据进行分析。
研究涉及来自三个地区的 11 名参与者,他们的工作经验各不相同。实施的潜在政策措施包括支持小组、家访、免费药物供应和咨询,这些措施可能会改善 HIV 感染者和合并症患者的 HRQoL。政策实施的障碍包括不遵守药物治疗、污名化、非传染性疾病(NCD)药物费用、获得 NCD 服务的机会问题、实施者缺乏兴趣或理解以及人员流动率高。促进因素包括在职培训、共同平台的准则、知识共享、外部资源、定期检查以及为患者提供激励方案。
患有合并症的 HIV 感染者面临着影响其 HRQoL 的复杂挑战,包括情感和财务方面的挑战。该研究确定了关键政策和障碍,突出了需要采取有针对性的、以患者为中心的方法。在职培训和定期检查等促进因素为有效的政策实施提供了可操作的见解,强调了改善合并症患者的健康结果。该研究建议采用综合护理方法和依从性支持计划,以解决 HIV 感染者面临的独特挑战。