Abstract

BackgroundPatients play a major role in the success of any antiretroviral treatment (ART) programme. Hence, their needs should be articulated on a regular basis for interventional processes to promote adherence, retention and quality care.AimThis study investigated whether patients’ needs were being met, described which needs were met, which were not and how such needs could be met.SettingThe study took place at four ART clinics in eThekwini district public hospitals.MethodsThis study formed part of a larger study that utilised a sequential mixed-methods design. However, only the qualitative component is documented herein. Twelve HIV-infected patients engaged in in-depth interviews (three patients from each of the four hospitals). A socio-ecological framework divided responses into four categories, namely, the individual, interpersonal, institutional and policy. Each category presented (1) patients’ needs that are being met, (2) needs that are not being met, (3) recommendations on how they can be met and (4) researchers’ observations.ResultsAll 12 patients reported that all their needs were not being met. They further shared their met needs, unmet needs and made recommendations for meeting their unmet needs. These needs varied per antiretroviral clinic because of unique processes at each institution.ConclusionTo adequately address the needs of HIV-infected patients, it is imperative for all stakeholders involved in the public ART programme to gain an understanding of what constitutes ‘patients’ needs’. The results reflect patients’ willingness to be involved in their care, treatment and interventional strategies to adequately meet their needs.

Highlights

  • The South African public antiretroviral treatment (ART) programme was initiated in 2003 and has been in operation for over 10 years.[1]

  • Because of the lack of a universally accepted definition of ‘patients’ needs’, the researcher commenced with a spill question to tease out the concept to ascertain what it meant to each participant: What does ‘patients’ needs’ at this ARV clinic mean to you?

  • Others were unaware who to report such incidents to, whilst some did not trust that their complaints would be taken seriously nor remain confidential: ‘... most of us are afraid as we have to come back to this clinic and the staff can be nasty if they know we reported them.’ (Participant 3, male, Hospital 1)

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Summary

Introduction

The South African public antiretroviral treatment (ART) programme was initiated in 2003 and has been in operation for over 10 years.[1]. The programme is free and includes patients, antiretroviral (ARV) drugs, ARV clinics and pharmacies, clinical and non-clinical staff. It includes laboratory testing, routine doctor consultations, blood tests, management of opportunistic infections and ARV side-effects, counselling, nutritional advice and support. Patients play a major role in the success of any antiretroviral treatment (ART) programme. Their needs should be articulated on a regular basis for interventional processes to promote adherence, retention and quality care

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