ArticleBMC public health2025
"Ashamed of being seen in an HIV clinic": a qualitative analysis of barriers to engaging in HIV care from the perspectives of patients and healthcare workers in the Daraja clinical trial.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03858998 (Reducing Post-Hospital Mortality in HIV-infected Adults in Tanzania), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reducing Post-Hospital Mortality in HIV-infected Adults in Tanzania
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Strategies for improving linkage to HIV care after hospital discharge among adults living with HIV in low- and middle-income countries: a systematic review.BMC public health · 2025Pooled it
- Self-Efficacy and One-Year HIV Outcomes for Hospitalized People with HIV in Tanzania: A Mediation Analysis of the Daraja Clinical Trial.AIDS and behavior · 2026Trial
- Cost-Effectiveness of Linkage Case Management for Hospitalized People With HIV.JAMA network open · 2025Trial
- Unawareness of HIV-Positive Status among Men in Seven Sub-Saharan African Countries: Age, Behavioral, and Structural Determinants.AIDS and behavior · 2026Article
- Factors associated with opting care from closer location to residence among PLHIV at Andhra Pradesh, India between 2023 and 2024.BMC health services research · 2026Article
- Article
- Social and Structural Interventions to Reduce Strikingly High Post-Hospital Mortality for People Living with HIV in Sub-Saharan Africa.Current HIV/AIDS reports · 2025Review
- Two Decades and Counting Since the Abuja Summit: Where Do We Stand in the Fight Against HIV/AIDS-Related Maternal Mortality?Women's health reports (New Rochelle, N.Y.) · 2025Article
- Tailoring Treatment for Substance Use Disorders in Older Adults: A Mixed-methods Study.Innovation in aging · 2025Article
- Perceived Enablers and Barriers to HIV Testing Service Uptake Among Adolescent Girls and Young Women in Kilimanjaro, Tanzania: A Contextual Analysis.Journal of the International Association of Providers of AIDS CareArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundThere is high post-hospital discharge mortality among persons with HIV who are hospitalized, and post-hospital survival is strongly associated with early HIV clinic linkage, clinic attendance, and antiretroviral therapy adherence. The Daraja intervention, a context-tailored case management strategy implemented and tested through a randomized trial in Tanzania, was associated with improved HIV clinic linkage, retention, and ART initiation and adherence.
methodsWe conducted in-depth interviews (IDIs) in a sub-sample of 40 study participants (20 control and 20 intervention) 12 months after enrollment into the trial to gain an in-depth understanding of the barriers to HIV care engagement and the perceived mechanisms through which the Daraja intervention impacted these barriers. We also conducted IDIs with 20 health care providers. We used a thematic analysis approach to generate themes following the Gelberg-Andersen behavioral model for vulnerable population domains.
resultsPerceived stigma, coupled with the mistrust of healthcare providers, underemployment or lack of reliable income, unreliable transport, and a lack of social support, were identified as key barriers to HIV clinic attendance and ART adherence. Perceived stigma complicated not only linking to and attending an HIV clinic but also decision-making regarding the choice of the clinic's location. The Daraja intervention was reported to help normalise HIV diagnosis, plug the social support gap, increase patients' self-efficacy and their capacity of participants to navigate the HIV clinic during HIV clinic linkage.
conclusionThese qualitative research results identified several important barriers to engaging in HIV care and provide insights into the mechanisms through which the Daraja intervention operated to affect the perceived stigma, social support, self-efficacy, and increased capacity of participants to navigate the HIV clinic during HIV clinic linkage. DARAJA
trial registrationClinicalTrials.gov, NCT03858998. Registered on 01 March 2019.
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