"Can't you initiate me here?": Challenges to timely initiation on antiretroviral therapy among methadone clients in Dar es Salaam, Tanzania

The International Journal on Drug Policy
Haneefa T SaleemBarrot H Lambdin

Abstract

Despite dramatic improvement in antiretroviral therapy (ART) access globally, people living with HIV who inject drugs continue to face barriers that limit their access to treatment. This paper explores barriers and facilitators to ART initiation among clients attending a methadone clinic in Dar es Salaam, Tanzania. We interviewed 12 providers and 20 clients living with HIV at the Muhimbili National Hospital methadone clinic between January and February 2015. We purposively sampled clients based on sex and ART status and providers based on job function. To analyze interview transcripts, we adopted a content analysis approach. Participants identified several factors that hindered timely ART initiation for clients at the methadone clinic. These included delays in CD4 testing and receiving CD4 test results; off-site HIV clinics; stigma operating at the individual, social and institutional levels; insufficient knowledge of the benefits of early ART initiation among clients; treatment breakdown at the clinic level possibly due to limited staff; and initiating ART only once one feels physically ill. Participants perceived social support as a buffer against stigma and facilitator of HIV treatment. Some clients also reported that persis...Continue Reading

References

Jun 14, 2006·Drug and Alcohol Dependence·Sheryl A McCurdyMark L Williams
Nov 30, 2006·Psychology, Health & Medicine·Miriam Heijnders, Suzanne Van Der Meij
Aug 5, 2008·JAMA : the Journal of the American Medical Association·Evan WoodJulio S G Montaner
Nov 21, 2008·AIDS and Behavior·Monica MaltaFrancisco I Bastos
Sep 15, 2009·The International Journal on Drug Policy·Andrea KrüsiThomas Kerr
Oct 8, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Perrine RouxBruno Spire
Mar 2, 2010·Lancet·Bradley M MathersUNKNOWN 2009 Reference Group to the UN on HIV and Injecting Drug Use
Jun 29, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Kasama SukapiromKovit Pattanapanyasat
Jul 20, 2011·The New England Journal of Medicine·Myron S CohenUNKNOWN HPTN 052 Study Team
Aug 9, 2012·The Journal of the Association of Nurses in AIDS Care : JANAC·Megha RamaswamyJulia H Arnsten
Nov 12, 2013·The International Journal on Drug Policy·R Douglas BruceGad Kilonzo
May 24, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Barrot H LambdinR Douglas Bruce
Aug 7, 2014·AIDS and Behavior·Monica da SilvaLara M E Vaz
Nov 27, 2014·PloS One·Malin MalagunJessica Markby
May 20, 2015·Current HIV Research·Barrot H LambdinPaul Volberding
May 27, 2015·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Olivia C TranBarrot H Lambdin
Jul 24, 2015·Journal of the International AIDS Society·Barrot H LambdinRobert D Bruce

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Citations

Mar 22, 2016·The International Journal on Drug Policy·Tim Rhodes, Reychad Abdool
Apr 21, 2017·Canadian Journal of Public Health = Revue Canadienne De Santé Publique·Bobbi BrownriggGina Ogilvie
Mar 3, 2019·International Journal of Environmental Research and Public Health·Saria HassanBarrot H Lambdin

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