Health system barriers to collaborative HIV/TB activities in Russia (health providers’ opinion)

Abstract

Introduction. The increase in the number of HIV/TB coinfection cases along with the progression of the HIV epidemic requires strengthening of HIV/TB collaborative services, especially in providing the health care measures for PLWH. Study objectives. To determine health barri-ers in HIV/TB collaborative activities and to assess ways to overcome them according to the opinion of health providers of TB facilities. Study design. In the qualitative sociological study, surveys with open and closed ques-tions were distributed amongst 284 health care workers of TB facilities in St. Petersburg, Leningrad, Arkhangelsk, and Kaliningrad oblasts during six months of 2018. The regions in the study have been selected based on the features of the HIV, TB and HV/TB coinfection epide mics. Statistically 95.0% confident interval of the obtained data was assessed. Results. According to the opinion of specialists of TB facilities, the main barriers to imple-mentation of HIV/TB collaborative services are: low levels of stakeholder engagement, including penitentiary sys-tem (24.4%), increased migration (48,0%) and increase in the number of injecting drug users in some of regions (76.0%), insufficiency of legal policy caused mainly by its conflicting (56,0%) and limitation in funding for TB measures (56.0%). Conclusion. In the health providers’ opinion enhancement of existing HIV/TB strategy should be done by strengthening stakeholder engagement, es-pecially with the penitentiary system, fully financing of TB measures, improving work with migrants, injecting drug users, including the establishment of low-threshold centers.