The Impact of Integrated Adherence Support services on TB/HIV Co-infected patients health care utilization

Abstract

Adherence support services in the provision of healthcare have previously been known in various diseases and contexts. Aimed mainly at giving psychosocial support for people with HIV/AIDS, individuals in psychosocial and behavioral disorders as well as substance abuses by people in similar situation, peer counseling service was mainly known to be delivered in such conditions as in an established social networks, community organizations, family settings as well as work place environments, among others. Institutional based peer support services as adherent support services for TB/HIV co-infection has been relatively a recent phenomenon. In Ethiopia, the approach has being used in ART clinics as an integral part of the collaborative care services for TB/HIV co-infected patients. However, there is limited knowledge regarding its impact on the co-infected patients’ healthcare utilization. The central purpose of this study is to investigate the impact of integrating Peer approach as Adherence support services on TB/HIV Co-infected Patients healthcare utilization as explained by the patients’ medication adherence and retention in care services. The study has adopted a qualitative research approach recruiting participants from TB/HIV co-infected patients, lay peer counselors as well as professional health workers in two ART clinics of two public hospitals located in two Regional States (Addis Ababa and Oromia) in Ethiopia. The study revealed that the integration of peer counselors in the ART clinics played a substantial significance role in enabling TB/HIV co-infected patients adhere to their medications and utilize their care services. Giving experiential information with respect to medication, strategies of managing social effects of the disease and clinical effects of medications, have been found some of the critical importance of institutionalizing the service. However, though with varying degrees, factors such as Health Belief and Patient attitudes, patients Socio-Economic Factors as well as Medication Related Factors are still found to be negatively impacting TB/HIV co-infected patients health services Utilization. The study also showed that the TB/HIV integrated services could be made more effective by addressing the human and physical constraints as well as training needs of the peer counselors.