HIV and TB co-infection: A double ethical challenge in South African public hospitals

Abstract

Managing patients with human immunodeficiency virus (HIV) and Tuberculosis (TB) or those with co-infections of HIV and TB (HIV/TB) requires close interactions between patients and health care professionals (HCPs). However, ethical principles contradicting ethical practice pose challenges for these patients. This survey based cross-sectional study used a questionnaire with three sections for HCPs, consisting of nurses, physiotherapists , occupational, speech and audiology therapists from three public hospitals, in South Africa. This study found 92% HCPs experienced ethical challenges with HIV/TB patients. Limited hospital resources, non-adherence to ethical principles, stigma, discrimination and fear of cross infection were contributing negative perceptions towards these patients . Challenges experienced with HIV/TB patients requires concerted and sustained interventions to overcome in clinical practice. These are, but not limited to, priority to improve public hospital resources, implement guidelines, policies and education to encourage and enhance ethical principles and practice to ameliorate ethical challenges with HIV/TB patients.