Patient Perspectives of Quality of the Same-Day Antiretroviral Therapy Initiation Process in Gauteng Province, South Afr
- PDF / 747,982 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 102 Downloads / 168 Views
ORIGINAL RESEARCH ARTICLE
Patient Perspectives of Quality of the Same‑Day Antiretroviral Therapy Initiation Process in Gauteng Province, South Africa: Qualitative Dominant Mixed‑Methods Analysis of the SLATE II Trial Nancy A. Scott1 · Mhairi Maskew2 · Rachel M. Fong1 · Ingrid E. Olson1 · Alana T. Brennan1,2,3 · Matthew P. Fox1,2,3 · Lungisile Vezi2 · Peter D. Ehrenkranz4 · Sydney Rosen1,2
© The Author(s) 2020
Abstract Background HIV patients in South Africa continue to report operational barriers to starting antiretroviral therapy (ART). In the Simplified Algorithm for Treatment Eligibility (SLATE) II trial, same-day initiation (SDI) of ART increased the number of patients commencing ART and achieving HIV viral suppression by using a screening tool to distinguish between patients eligible for SDI and those requiring additional care before starting treatment. We conducted a mixed-methods evaluation to explore trial patients’ perceptions and experiences of SDI. Methods SLATE II was implemented at three urban, public primary health care clinics in Gauteng Province, South Africa. We conducted a short quantitative survey and in-depth interviews among a purposive sample of 89 of the 593 trial participants in the intervention and standard arms, using a mixed inductive–deductive framework approach. Results Nearly all respondents (95%) were satisfied with their care, despite reporting clinic wait times of ≥ 3 h (72%). Intervention patients found the initiation process to be easy; standard patients found it complicated and were frustrated with being shuffled around the clinic. No intervention arm patients felt that SDI was “too fast” or indicated a preference for a more gradual process. Both groups highlighted the need for good counselling and non-judgmental, respectful staff. Standard patients suggested improving patient–provider relations, strengthening counselling, reducing wait times, and minimising referrals. Conclusions While it is difficult to untangle the role of providers from that of the SLATE algorithm in influencing patient experiences, adoption of SLATE II implementation procedures could improve patient experience of treatment initiation. Trial registration Clinicaltrials.gov NCT03315013, registered October 19, 2017. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40271-020-00437-4) contains supplementary material, which is available to authorized users.
Abbreviations ART Antiretroviral therapy IDI In-depth interview
* Nancy A. Scott [email protected]
Peter D. Ehrenkranz [email protected]
Mhairi Maskew [email protected]
Sydney Rosen [email protected]
Rachel M. Fong [email protected]
1
Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave 3rd Floor, Boston, MA 02118, USA
2
Matthew P. Fox [email protected]
Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesbu
Data Loading...
