ArticleImplementation science : IS2011
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.
Article in Implementation science : IS, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Barriers and facilitators of rendering HIV services by community health workers in sub-Saharan Africa: a meta-synthesis.Family medicine and community health · 2021Pooled it
- Unpacking the dynamics of double stigma: how the HIV-TB co-epidemic alters TB stigma and its management among healthcare workers.BMC infectious diseases · 2020Trial
- Let's Talk!, A South African worksite-based HIV prevention parenting program.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2013Trial
- Exploring the needs of technical developers and stakeholders in point-of-care technology development: a qualitative study.BMJ open · 2026Article
- Examining global Indigenous community wellness worker models: a rapid review.International journal for equity in health · 2024Review
- Roles, Barriers, and Recommendations for Community Health Workers Providing Community-Based HIV Care in Sub-Saharan Africa: A Review.AIDS patient care and STDs · 2022Review
- Article
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- Quality of TB care among people living with HIV: Gaps and solutions.Journal of clinical tuberculosis and other mycobacterial diseases · 2019Review
- Healthcare worker experiences with Option B+ for prevention of mother-to-child HIV transmission in eSwatini: findings from a two-year follow-up study.BMC health services research · 2019Article
- Relationship and career challenges faced by people infected with HIV in Malaysia.F1000Research · 2019Article
- Integrating innovations: a qualitative analysis of referral non-completion among rapid diagnostic test-positive patients in Uganda's human African trypanosomiasis elimination programme.Infectious diseases of poverty · 2018Article
- Integrating home HIV counselling and testing into household TB contact investigation: a mixed-methods study.Public health action · 2018Article
- Community-based directly observed treatment for TB patients to improve HIV services: a cross-sectional study in a South African province.BMC health services research · 2018Article
- Lay health worker experiences administering a multi-level combination intervention to improve PMTCT retention.BMC health services research · 2018Article
- Can lay health workers support the management of hypertension? Findings of a cluster randomised trial in South Africa.BMJ global health · 2018Article
- A guide to aid the selection of diagnostic tests.Bulletin of the World Health Organization · 2017Article
- A qualitative exploration of cervical and breast cancer stigma in Karnataka, India.BMC women's health · 2017Article
- Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State Province, South Africa.Southern African journal of HIV medicine · 2017Article
- Article
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSouth 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.
methodsGroup 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.
resultsThe 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 facilitating factors emerging from the group and individual interviews were (1) encouragement and motivation by health workers, (2) alleviation of health worker shortages, (3) improved HCT training of professional and lay health workers, and (4) community outreach activities.
conclusionsOur findings provide insight into the relatively low acceptance rate of HCT services among TB patients from the perspective of two healthcare workforce groups that play an integral role in the delivery of effective health services and programs. Community health workers and program managers emphasized several patient- and delivery-level factors influencing acceptance of HCT services.
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