Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Patient- and delivery-level factors related to acceptance of HIV counseling and testing services among tuberculosis patients in South Africa: a qualitative study with | Heunis et al. Implementation Science 2011 6 27 http content 6 1 27 IMPLEMENTATION SCIENCE Implementation Science RESEARCH Open Access Patient- and delivery-level factors related to acceptance of HIV counseling and testing services among tuberculosis patients in South Africa a qualitative study with community health workers and program managers 1 2 3 1 14 J Christo Heunis Edwin Wouters Wynne E Norton Michelle C Engelbrecht N Gladys Kigozi Anjali Sharma Camille Ragin5 Abstract Background South Africa has a high tuberculosis TB -human immunodeficiency virus HIV coinfection rate of 73 yet only 46 of TB patients are tested for HIV. To date relatively little work has focused on understanding why TB patients may not accept effective services or participate in programs that are readily available in healthcare delivery systems. The objective of the study was to explore barriers to and facilitators of participation in HIV counseling and testing HCT among TB patients in the Free State Province from the perspective of community health workers and program managers who offer services to patients on a daily basis. These two provider groups are positioned to alter the delivery of HCT services in order to improve patient participation and ultimately health outcomes. Methods Group discussions and semistructured interviews were conducted with 40 lay counselors 57 directly observed therapy DOT supporters and 13 TB and HIV acquired immune deficiency syndrome AIDS program managers in the Free State Province between September 2007 and March 2008. Sessions were audio-recorded transcribed and thematically analyzed. Results The themes emerging from the focus group discussions and interviews included four main suggested barrier factors 1 fears of HIV AIDS TB-HIV coinfection death and stigma 2 perceived lack of confidentiality of HIV test results 3 staff shortages and high workload and 4 poor infrastructure to encourage monitor and deliver HCT. The four main .
