Personal Health Services Research Articles

Factors influencing healthcare access for persons with disabilities in Kakamega County, Kenya during COVID-19: A qualitative study

INTRODUCTION Access to healthcare for persons with disabilities is an indicator of the overall effectiveness of the healthcare system in terms of equity, accessibility and the right to health. This study explores factors affecting access to healthcare among persons with disabilities in Kakamega County in the context of COVID-19. MATERIALS AND METHODS Materials used in this study are part of a larger study that looked at access to healthcare and its effect on the quality of life of persons with disabilities in Kakamega County. In this paper, we present data generated from the qualitative component of the study that comprised 7 focus group discussions, 15 in-depth interviews, and 8 key informants who provided contextual information on health services for persons with disabilities. Data was coded and analysed thematically. RESULTS The study established key barriers to healthcare access for persons with disabilities during the COVID-19 pandemic period ranging from availability, affordability, discrimination, accommodation, assistive devices, and appropriateness of healthcare. In addition, the results show that these obstacles are not limited to the pandemic, but represent everyday challenges that persons with disability experience; but were exacerbated during the pandemic. CONCLUSION AND RECOMMENDATIONS This study highlights the need for disability-friendly infrastructure in healthcare facilities, subsidized medical costs, and the provision of assistive technologies to improve healthcare access for persons with disabilities. We also recommend increasing community and provider awareness of disability rights, enforcing existing laws and policies, and ensuring equal employment opportunities to support full social participation for individuals with disabilities.

The trajectories and associations of sleep disturbance symptoms with suicidal ideation in adolescents: A three-wave longitudinal study

BackgroundThis study aimed to investigate the developmental trajectories of sleep disturbance symptoms and examine whether specific trajectory memberships of sleep disturbance symptoms could prospectively predict suicidal ideation (SI) among a large sample of Chinese adolescents over one year. MethodsA three-wave longitudinal study was conducted from April 2021 to June 2022, with a sample of 19,095 adolescents from Shenzhen in Guangdong Province, China (51.2% males; mean age = 12.4 ± 1.6 years at baseline). Socio-demographics (at baseline), SI, sleep disturbance symptoms (at each assessment), depressive symptoms (at the last follow-up), and negative life events (at two follow-ups) were assessed. Data were analyzed employing Growth Mixture Modeling and binary logistic regressions. ResultsThe Growth Mixture Modeling identified four trajectories of sleep disturbance symptoms over one year: resistant group (76.2%), delayed-dysfunction group (8.8%), recovery group (7.4%), and chronic-dysfunction group (7.6%). Binary logistic regression analysis revealed that adolescents in the group of delayed-dysfunction (OR = 2.86, 95% CI = 2.51-3.27) and chronic-dysfunction (OR = 2.14, 95% CI = 1.84-2.47) exhibited higher risks of developing SI compared to those in the resistant group, even after controlling for socio-demographics, negative life events, depressive symptoms, and baseline SI. ConclusionsThese findings underscore the importance of identifying individuals at higher risks of sleep disturbance and providing personalized and effective mental health services to reduce the incidence of SI.

Utilization and features of rehabilitation and health services for persons with spinal cord injury.

The increasing prevalence of individuals experiencing disabilities underscores the importance of rehabilitation. Nevertheless, healthcare systems are already facing financial constraints, which makes it imperative to strive for a more efficient delivery of services. The first step, however, is to understand how the provision of services behaves for patients with different characteristics. To determine the most frequently used healthcare services in the (sub)acute phase of rehabilitation of patients with spinal cord injury/disease (SCI/D) and the link with patient characteristics. Observational cohort study. This study analyzes the clinical data of patients discharged from a specialized SCI hospital and rehabilitation center in Switzerland. We implemented a compound risk model to estimate the total amount of healthcare services used, defined by length of stay (LOS) and the units per day of health services (sub)acute phase of rehabilitation. The study included 403 individuals with SCI/D. The analysis of the intensity and severity of healthcare services across different patient and injury characteristics revealed differences in the intensity of healthcare use and variations in the length of stay (LOS). Male patients with a low SCIM upon admission tended to use healthcare services more extensively than female patients. In terms of etiology, therapies were employed more intensively for patients with traumatic SCI (TSCI). In addition, the analysis revealed that variations in the intensity of healthcare services used were more significant than those adjusted for LOS. Ultimately, similar patient groups received comparable quantities of healthcare services at the end of treatment. This population-based study provides information for a better understanding of the determinants of health service use during the (sub)acute rehabilitation phase of individuals with SCI/D. When analyzing LOS, intensity, and severity of services, it shows that the use of healthcare services significantly differs for the level of SCIM at admission, age groups, sex, and etiology. However, the variation among individual patients also suggests the presence of other influential modifiers that were not considered in this analysis. The approach outlined enables a systematic follow-up of this data analysis by enriching the computed data with additional details about the patient, the patient's treatment, and outcomes.

Assessment of the feasibility of a community-based mental health training programme for persons with disabilities by non-specialists from different stakeholders’ perspectives in Bangladesh

IntroductionBangladesh is a developing country where 11% of the population has at least one disability, but no community-level mental health service is available. There is limited evidence of the burden of mental health issues and health-seeking behaviour among this population. This study assessed the feasibility of a training intervention for persons with disabilities, where peer support providers provided community-based disability-inclusive mental health services.MethodsFour stakeholder groups participated in this qualitative study: peer responders (trained persons with disabilities), trainers, representatives of organisations of persons with disabilities and disability-specific organisations, and officials of international and national non-governmental organisations. Two types of qualitative interviews were used to collect data, and thematic analysis techniques were utilised.ResultStakeholders perceived the peer responder training programme as acceptable for persons with disabilities to develop themselves as peer support providers, with potential benefits including increased mental health literacy, ensuring accessible mental health services, and improving the well-being of persons with disabilities. Potential challenges included receiving training and delivering services. Increased training duration, more fieldwork, supervision opportunities, and refresher training were recommended to mitigate training challenges. Financial support and formal community recognition were deemed necessary for training delivery.ConclusionThe peer responder training programme was feasible to ensure accessible mental health services for persons with disabilities, build a workforce to screen for mental health conditions, and provide appropriate referrals. A multi-sectoral collaboration of government and non-governmental institutions is recommended to policy advocates to expand the peer responder training programme in the mainstream mental healthcare system.

SNS 기반 모바일 정신건강서비스 플랫폼 이용경험에 관한 현상학적 연구

This study is a phenomenological study on the experience of using a mobile mental health service platform developed and provided by mental health social welfare experts, and was conducted to provide practical policy and practical suggestions for the necessity of a mobile mental health service platform and the use of a professional mobile mental health service platform in Korea's mental health service delivery system. To this study, data were collected from 12 research participants who have been continuously using the platform for more than a year, and the data were analyzed by applying Giorgi's phenomenological perspective to deeply analyze the nature and meaning of the experience of the phenomenon. As a result of the analysis, 7 components and 20 sub-components were derived, and the components were found to struggle in the beginning and despair of the problem, mental health services I used and negative memories, various mental health services experienced in accidental spaces, reasons for continuing to find the mobile mental health service platform, psychological stability and practical change and recovery, limitations of personal mobile mental health service platforms, and partnerships with public mental health services. Based on these analysis results, the conclusions of this study and practical suggestions were presented.

Secure Cloud Storage and Retrieval of Personal Health Data From Smart Wearable Devices With Privacy-Preserving Techniques

With the increasing awareness of personal health, personal health data management has become an important part of people's lives. Smart wearable devices (SWDs) collect people's personal health data, and then store the data on cloud. Authorized entities access the data to provide personalized health services. However, these personal health data contain a large amount of sensitive information, which may pose a significant threat to people's lives and property. To address this, this paper proposes a privacy-preserving solution. SWD data is encrypted, and secure indexes are created using Bloom filter and 0-1 encoding. Encrypted data and indexes are stored in a semi-trusted cloud. Only authorized entities can access the ciphertexts, ensuring secure personalized health management. Extensive experiments validate the scheme's efficiency in index construction, query token generation, and ciphertext search. Security analysis confirms no external entity, including the cloud, gains additional information during retrieval.

Ability in Intellectual Disability: The Culture of Inequality in Nigeria and Other Jurisdictions

This paper examines the disputable issue of the culture of inequality in providing legal protection for children living with intellectual disabilities. It argues the disparity in the provision of educational and health services for persons living with intellectual disabilities by the Nigerian Government and identifies the gaps in the provisions of Sections 20 and 21 of the Nigerian Discrimination Act. These deficiencies obscure the ability of children living with disabilities (Down syndrome and Autism), which culminates in a domino effect from delayed intervention. It draws a comparative analysis from the United Kingdom and the United States of America as a standard for innovative legal frameworks in Nigeria. It concludes that non-governmental organisations must collaborate with the government to ameliorate Nigeria's poor education and health care, with a differential detour that rights to free education and health care for those with intellectual disabilities be justiciable for the Act's practicability.

293 Advance Care Planning in older persons mental health, insights from interdisciplinary healthcare professionals

Abstract Background Later life can be time where older persons face increasing health challenges and major decisions relating to future care. ‘Advance Care Planning’ (ACP) refers to a process of discussion and reflection about a person’s values, goals, and preferences for future care in case they lose the capacity to make decisions and communicate these in the future. The aim of this three-stage action research study is to collaboratively explore the perceptions and understanding of interdisciplinary team members and attendees of Mental Health Services for Older Persons (MHSOP) and their family carers in relation to ACP and to identify ways of improving decision-making practice considering the newly commenced Assisted Decision-Making (Capacity) Act (2015). Methods This presentation focuses on findings from stage one, which involved a survey administered via survey monkey, 3 focus groups and a feedback session with 22 interdisciplinary team members of a MHSOP from the fields of nursing, occupational therapy, psychology, psychiatry, and social work. Results Whilst there is already a culture of facilitating ACP with service users and their family carers within the MHSOP, however this is not routine practice. While clinicians largely recognised the value of ACP, 95% reported a lack of education, 52% a lack of knowledge of ACP tools, and limited experience in engaging with service users (53%) and family carers (47%). Identified barriers to engagement included lack of allocated time, clinician’s confidence, capacity issues and ‘a dedicated pathway across services with joined up conversation’. Conclusion Interdisciplinary professionals overwhelmingly recognised the importance of ACP with service users and family carers, and the positive impact ACP can have on end-of-life care. All indicated an eagerness for additional ACP guidelines and skills training for MHSOP staff.

Experiences of Food Pantry Stakeholders and Emergency Food Providers in Rural Minnesota Communities

ObjectiveThis study aimed to describe the experiences influencing food pantry stakeholders’ and emergency food providers’ ability to meet their shoppers’ needs. DesignWe conducted 5 focus groups. SettingFood pantries in Minnesota in late 2019 and early 2020. ParticipantsThe sample included 37 participants with various roles in the emergency food system. Phenomenon of InterestBarriers and challenges facing emergency food providers/stakeholders and practices and resources providers employ. AnalysisWe identified major themes using a thematic analysis approach. ResultsParticipants reported multiple barriers to accessing food pantries, that shopper demographics were changing, and shoppers needed nonfood support, such as personal hygiene items and mental health services. Food pantries required appropriate and sustainable food supplies, additional financial, labor, technical support, and physical infrastructure improvements. Participants described the benefits of their relationship with the University of Minnesota Cooperative Extension, explained how pantries offered healthier foods, highlighted innovative service delivery models, and stressed that their organization connected to many facets of their community. Conclusion and ImplicationsFood pantries serving rural areas reported meeting community needs by distributing food to their shoppers in an inclusive and health-promoting way but require additional support. These data support nutrition practitioners working to understand the local, place-based context and needs of emergency food providers while building wider and deeper connections between nutrition professionals and the emergency food system.

Examining COVID-19 testing and vaccination behaviors by heritage and linguistic preferences among Hispanic, Latino, or Spanish RADx-UP participants

The Hispanic, Latino, or Spanish (hereafter, “Hispanic”) populations in the U.S. bear a disproportionate burden of COVID-19-related outcomes, including disease incidence and mortality. Developing culturally appropriate national public health services for Hispanic persons remains a challenge. This study examined the association of heritage and language preference with COVID-19 testing (tested vs. not tested) and vaccination (vaccinated vs. not vaccinated) outcomes among Hispanic participants from 18 Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) projects (n = 3308; mean age = 44.1 years [SD = 14.9], 60% women; 83% spoke other than English at home). Generalized estimating equation models adjusted for age, gender, education level, income, insurance coverage, geographic region, comorbidities, and prior infection. Relative to Mexican heritage, individuals identifying as Puerto Rican or Dominican were more likely to test for COVID-19, and South American heritage was associated with higher testing and vaccination rates. Speaking Spanish or another language at home was associated with increased testing compared with speaking English at home for individuals who preferred not to report their heritage, and increased vaccination for those with Mexican, Cuban, or Central American heritage. This study highlights heterogeneity in testing and vaccination behaviors among Hispanic populations based on heritage and language preference, underscoring the diversity within the U.S. Hispanic community. In contrast to other studies on linguistic acculturation and health care utilization, our study found that a language other than English spoken at home was associated with greater vaccine uptake. That is, enculturation – the retention of Spanish language and presumably of Hispanic cultural norms – was linked with being vaccinated.

Risk and Protective Factors Associated with Post-Tornado Distress among Persons with Disabilities

This study examined the direct effects of tornado exposure and protective resources on post-disaster distress among (N = 209) persons with disabilities following a tornado outbreak in the Midwest and Southeast on December 10–11, 2021 using structural equation modeling. Results found the degree of tornado exposure (e.g., injury, loss of loved ones, property damage, etc.) increased the likelihood of experiencing higher levels of PTSD and depression. Results also found that higher levels of protective resources (physical, social, and emotional) were found to protect against post-tornado PTSD and depression. Findings can inform future post-disaster mental health services for persons with disabilities.

Association of inability to secure timely medical appointment and medication non-adherence among cancer survivors in the US.

e18595 Background: Access to health care is defined as the “timely use of personal health services to achieve the best possible health outcomes.” Cancer survivors have higher health care utilization than individuals without a history of cancer, yet studies examining health care access and its impact on medication adherence in this population are lacking. Methods: Study data were derived from the National Health Interview Survey. The prevalence of reports of inability to secure timely medical appointment among cancer survivors was estimated by respondent characteristics. Weighted multivariable logistic regressions were used to assess the relationship between inability to secure timely medical appointment and medication non-adherence among Cancer Survivors in the US. Results: Respondents were a total of 2,590 cancer survivors, of which 8.9% (n = 225) reported inability to secure timely medical appointment. The prevalence of reports of inability to secure timely medical appointment were higher among those without insurance coverage (17.3%), earning income < $34,999 (12.3%), those aged 18-45 years (15.9%), American Indian natives (32.2%), and females (10.4%). The odds of skipping medication to save money was almost four-fold higher for cancer survivors who were unable to secure timely medical appointment (adjusted odds ratio (aOR) 3.84; 95% CI: 2.19-6.74), compared to those who did not experience delays securing medical appointment. Similarly, the odds of taking less medication to save money was almost five-fold higher for cancer survivors who were unable to secure timely medical appointment (aOR 4.99; 95% CI: 2.83-8.77), compared to those who did not experience delays securing medical appointment. The association remained significant even after adjusting for potential confounding factors. Conclusions: This study found a significant association between inability to secure timely medical appointment and medication non-adherence among cancer survivors in the United States. These findings highlight the importance of timely medical care for cancer survivors and the potential consequences of delay in getting medical appointments, such as medication non-adherence. Interventions aimed at reducing delay in accessing medical care and improving medication adherence may improve outcomes among cancer survivors.

The development, implementation, and evaluation of an optimal model for the case detection, referral, and case management of Neglected Tropical Diseases.

People affected by Neglected Tropical Diseases (NTDs), specifically leprosy, Buruli ulcer (BU), yaws, and lymphatic filariasis, experience significant delays in accessing health services, often leading to catastrophic physical, psychosocial, and economic consequences. Global health actors have recognized that Sustainable Development Goal 3:3 is only achievable through an integrated inter and intra-sectoral response. This study evaluated existing case detection and referral approaches in Liberia, utilizing the findings to develop and test an Optimal Model for integrated community-based case detection, referral, and confirmation. We evaluate the efficacy of implementing the Optimal Model in improving the early diagnosis of NTDs, thus minimizing access delays and reducing disease burden. We used a participatory action research approach to develop, implement, and evaluate an Optimal Model for the case detection, referral, and management of case management NTDs in Liberia. We utilized qualitative and quantitative methods throughout the cycle and implemented the model for 12 months. During the implementation of our optimal model, the annual number of cases detected increased compared to the previous year. Cases were detected at an earlier stage of disease progression, however; gendered dynamics in communities shape the case identification process for some individuals. Qualitative data showed increased knowledge of the transmission, signs, symptoms, and management options among community health workers (CHW). The results provide evidence of the benefits of an integrated approach and the programmatic challenges to improve access to health services for persons affected by NTDs. The effectiveness of an integrated approach depends on a high level of collaboration, joint planning, and implementation embedded within existing health systems infrastructure.

The Relationship between BPJS Patient Satisfaction Level and Service Quality in Hospitals

Hospital is a health service institution that provides comprehensive personal health services, including medical services, medical rehabilitation and maintenance services. These services are carried out through the emergency department, outpatient unit and inpatient unit. Specialists and subspecialist doctors in hospitals provide outpatient services. By reviewing published works in 10 journals from 2015 to 2022, we examine the relationship between BPJS patient satisfaction level and service quality with the keywords service satisfaction journal search, BPJS, and Hospitals. The analytical tool used was PICO. The results of the study found that based on satisfaction indicators, there were seven dissatisfied journals (66.7%) on all the hands described (Tangibility, Reliability, Responsiveness, Assurance and Empathy) from 9 journals (90%) dissatisfied with BPJS services in hospitals. Patient satisfaction will impact the quality of service in a hospital.

The Perils of Medicalization for Population Health and Health Equity.

Policy Points Medicalization is a historical process by which personal, behavioral, and social issues are increasingly viewed through a biomedical lens and "diagnosed and treated" as individual pathologies and problems by medical authorities. Medicalization in the United States has led to a conflation of "health" and "health care" and a confusion between individual social needs versus the social, political, and economic determinants of health. The essential and important work of population health science, public health practice, and health policy writ large is being thwarted by a medicalized view of health and an overemphasis on personal health services and the health care delivery system as the major focal point for addressing societal health issues and health inequality. Increased recognition of the negative consequences of a medicalized view of health is essential, with a focus on education and training of clinicians and health care managers, journalists, and policymakers.

Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries

Objective To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI). Design Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos et al., 2003) and access to health services was established using univariable and multivariable logistic regression analysis, adjusted for socio-demographic and health status characteristics. Setting Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland. Participants 6658 adults with chronic SCI. Intervention None. Outcome measures Share of persons with SCI that reported unmet healthcare needs as a measure of access. Results Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs. Conclusions In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.

Liquid Health. Medicine in the age of surveillance capitalism

Digital health technologies transform practices, roles, and relationships in medicine. New possibilities for a ubiquitous and constant data collection and the processing of data in real-time enable more personalized health services. These technologies might also allow users to actively participate in health practices, thus potentially changing the role of patients from passive receivers of healthcare to active agents. The crucial driving force of this transformation is the implementation of data-intensive surveillance and monitoring as well as self-monitoring technologies. Some commentators use terms like revolution, democratization, and empowerment to describe the aforementioned transformation process in medicine. The public debate as well as most of the ethical discourse on digital health tends to focus on the technologies themselves, mostly ignoring the economic framework of their design and implementation. Analyzing the transformation process connected to digital health technologies needs an epistemic lens that also considers said economic framework, which I argue is surveillance capitalism. This paper introduces the concept of liquid health as such an epistemic lens. Liquid health is based on Zygmunt Bauman's framing of modernity as a process of liquefaction that dissolves traditional norms and standards, roles, and relations. By using liquid health as an epistemic lens, I aim to show how digital health technologies reshape concepts of health and illness, change the scope of the medical domain, and liquify roles and relationships that surround health and healthcare. The basic hypothesis is that although digital health technologies can lead to personalization of treatment and empowerment of users, their economic framework of surveillance capitalism may undermine these very goals. Using liquid health as a concept allows us to better understand and describe practices of health and healthcare that are shaped by digital technologies and the specific economic practices they are inseparably attached to.

Contextual Factors Associated with Abuse of Home-Dwelling Persons with Dementia: A Cross-Sectional Exploratory Study of Informal Caregivers.

One in six community-dwelling older adults experience elder abuse yearly, and persons with dementia are especially at risk. Although many risk factors for elder abuse have been identified, there are still knowledge gaps concerning risk and protective factors. This cross-sectional survey among Norwegian informal caregivers (ICGs) aimed to find individual, relational, and community factors associated with psychological and physical abuse of home-dwelling persons with dementia. This study involved 540 ICGs and was conducted from May to December 2021. Statistical analysis using penalized logistic regression with lasso was performed to find covariates associated with psychological and physical elder abuse. The most prominent risk factor for both subtypes of abuse was the caregiver being a spouse. In addition, risk factors for psychological abuse were having a higher caregiver burden, experiencing psychological aggression from the person with dementia, and the person with dementia being followed up by their general practitioner. For physical abuse, the protective factors were the ICG being female and having an assigned personal municipal health service contact, while the risk factors were the ICG attending a caregiver training program and experiencing physical aggression from the person with dementia and the person with dementia having a higher degree of disability. These findings add to the existing knowledge of risk and protective factors in elder abuse among home-dwelling persons with dementia. This study provides relevant knowledge for healthcare personnel working with persons with dementia and their caregivers and for the development of interventions to prevent elder abuse.

Remote Health Monitoring System for Patients

In this paper, we introduce the Virtual Clinic, a hardware and software system that enables patients and doctors to communicate remotely. To utilize the system, patients must have a wearable medical device and a mobile phone, while doctors require access to a computer device. The Virtual Clinic allows for the quick exchange of vital data and messages between patients and doctors, and even employs machine learning techniques to diagnose diseases automatically. This system provides the opportunity to use telemedicine and telehealth concepts to remotely monitor a patient's health, offer personalized health services, manage drug treatments, handle chronic illnesses, provide psychological services, give second opinions, collaborate on treatments, and quickly respond to emergencies. Our Virtual Clinic system, which utilizes IoT, network, and cloud technologies, is a versatile tool suitable for individuals, medical clinics and trainers alike.

Women living with HIV, diabetes and/or hypertension multi-morbidity in Uganda: a qualitative exploration of experiences accessing an integrated care service

PurposeWomen experience a triple burden of ill-health spanning non-communicable diseases (NCDs), reproductive and maternal health conditions and human immunodeficiency virus (HIV) in sub-Saharan Africa. Whilst there is research on integrated service experiences of women living with HIV (WLHIV) and cancer, little is known regarding those of WLHIV, diabetes and/or hypertension when accessing integrated care. Our research responds to this gap.Design/methodology/approachThe INTE-AFRICA project conducted a pragmatic parallel arm cluster randomised trial to scale up and evaluate “one-stop” integrated care clinics for HIV-infection, diabetes and hypertension at selected primary care centres in Uganda. A qualitative process evaluation explored and documented patient experiences of integrated care for HIV, diabetes and/or hypertension. In-depth interviews were conducted using a phenomenological approach with six WLHIV with diabetes and/or hypertension accessing a “one stop” clinic. Thematic analysis of narratives revealed five themes: lay health knowledge and alternative medicine, community stigma, experiences of integrated care, navigating personal challenges and health service constraints.FindingsWLHIV described patient pathways navigating HIV and diabetes/hypertension, with caregiving responsibilities, poverty, travel time and cost and personal ill health impacting on their ability to adhere to multi-morbid integrated treatment. Health service barriers to optimal integrated care included unreliable drug supply for diabetes/hypertension and HIV linked stigma. Comprehensive integrated care is recommended to further consider gender sensitive aspects of care.Originality/valueThis study whilst small scale, provides a unique insight into the lived experience of WLHIV navigating care for HIV and diabetes and/or hypertension, and how a “one stop” integrated care clinic can support them (and their children) in their treatment journeys.