Scientific Publication

Why are HIV-infected people not started on antiretroviral therapy? A mixed-methods study from Gujarat, India

author(s) Chawla, S. - Shringarpure, K. - Modi, B. - Sharma, R. - Rewari, B.B.. - Shah, A.N.. - Verma, P.B.. - Dongre, A.R.. - Kumar, A.M.V.
from UK Foreign, Commonwealth & Development Office (FCDO)
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themes
regions
  • Northern Europe
  • Europe
  • World
  • Southern Asia
  • Asia
citation

Chawla S, Shringarpure K, Modi B, Sharma R, Rewari BB, Shah AN, Verma PB, Dongre AR, Kumar AM V. Why are HIV-infected people not started on antiretroviral therapy? A mixed-methods study from Gujarat, India. Public Health Action. 2017;7(3):183–92

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Abstract

Setting 5 purposively selected antiretroviral therapy (ART) centres in Gujarat, India Objectives To assess the proportion of ART-eligible people living with the human immunodeficiency virus (PLHIV) who were not initiated on ART within 2 months of being recorded as eligible, to identify factors associated with non-initiation and to explore reasons from the provider’s perspective. Design The authors used a mixed-methods design (triangulation) of 1) a quantitative phase involving record reviews and cohort analysis (Poisson regression) of PLHIV registered during April 2014–March 2015, and 2) a qualitative phase involving one-to-one interviews with 25 providers Conclusion Several patient subgroups at greater risk of ART non-initiation were identified, along with reasons for risk; this has important programme implications for achieving the UNAIDS 90–90–90 goal, and particularly the second 90 component of having 90% of diagnosed PLHIV start ART. This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)

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