Chireshe Rumbidzai, Manyangadze Tawanda, Naidoo Keshena
Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa.
Department of Geosciences, School of Geosciences, Disasters, and Development, Faculty of Sciences and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.
BMC Health Serv Res. 2025 Jun 9;25(1):817. doi: 10.1186/s12913-025-12949-6.
People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients' lived experiences and expectations is vital for designing responsive service-delivery models.
A cross-sectional, descriptive, qualitative study was conducted at primary healthcare facilities in Harare, Zimbabwe. Semi-structured interviews were conducted with 20 adults diagnosed with both HIV infection and T2DM. The data were transcribed, translated (where necessary), and analyzed using thematic analysis.
Four overarching themes emerged: (1) fragmented versus integrated care (2), time and out-of-pocket expenses (3), healthcare provider attitudes and behaviours, and (4) unmet needs and expectations. Participants reported challenges, such as multiple appointments, financial burdens, lack of confidentiality, and limited counselling. Positive experiences included culturally competent care and integrated service delivery, where available.
Primary care services should be restructured to provide integrated, holistic, and patient-centered care for individuals with HIV and T2DM comorbidities. Health provider training, infrastructure development, and access to medication are key to improving the outcomes.
感染人类免疫缺陷病毒（HIV）且合并2型糖尿病（T2DM）的患者需要综合且以患者为中心的护理。然而，初级医疗保健系统在满足患有多种疾病患者的需求方面一直进展缓慢。了解患者的生活经历和期望对于设计响应式服务提供模式至关重要。
在津巴布韦哈拉雷的初级医疗保健机构开展了一项横断面、描述性定性研究。对20名被诊断同时感染HIV和患有T2DM的成年人进行了半结构化访谈。对数据进行转录、翻译（必要时），并使用主题分析法进行分析。
出现了四个总体主题：（1）分散护理与综合护理（2）、时间和自付费用（3）、医疗服务提供者的态度和行为，以及（4）未满足的需求和期望。参与者报告了一些挑战，如多次预约、经济负担、缺乏保密性和咨询有限。积极的经历包括具备文化胜任力的护理以及（在可行的情况下）综合服务提供。
应重组初级保健服务，为合并HIV和T2DM的个体提供综合、全面且以患者为中心的护理。医疗服务提供者培训、基础设施发展和药物可及性是改善治疗效果的关键。
