Perspectives of health care provider regarding TB-HIV referral strategy and non-uptake of HIV testing in Delhi – A qualitative study

Abstract

BackgroundDOTS provider and medical officer play an integral role in implementation of RNTCP. Understanding provider perspectives is an integral component of evaluating programme to improve services to identify the areas for quality improvement and universal HIV testing among TB patients. ObjectiveTo describe the perception of health care providers regarding TB-HIV referral strategy and reasons for non-uptake of HIV testing. MethodologyA qualitative study was undertaken at DOTS cum microscopic centre of TB-Chest clinic of Lok Nayak Hospital and DOTS cum microscopic centre of rural area of west Delhi. In-depth interview of DOTS provider and medical officer in-charge at DOTS centre was conducted. A topic outline guide used to assess the perception of study subjects. Thematic analysis of qualitative data was done. ResultsThe source of knowledge regarding HIV testing among DOTS providers were training and monthly review meetings. All the study participants knew the rational of HIV testing and the consequences of not being tested and are highly motivated for referring the patients for HIV testing at the earliest. Some of the barriers to HIV testing reported by the health care providers were lack of awareness, associated stigma, long distance travel by the patients and non-availability of HIV testing kits. ConclusionHealth care providers were motivated for implementation of the strategy. Barriers to HIV TB testing strategy should be addressed.