Newly diagnosed HIV individuals: Barriers to timely entrance into care after adopting treat all policy

ABSTRACT

Background

Vietnam has adopted ‘treat all’ guidelines since mid-2017. However, this can lead to a significant increase in ART coverage only if PLHIV go on to start treatment. In Vietnam, in 2017, approximately half of infected people were not able to access to treatment due to different types of barriers.

Method

We applied a qualitative method nested within a cohort study that investigated patient flow from HIV diagnosis to initiation of ART in the province of Ninh Binh. Data was collected at the end of 2017, comparing with baseline in 2015.

Results

Almost constraints for care found were structural with the most common was socio stigma. The lack of basic information on HIV treatment has led to delayed access to care, in the meantime, misconception about HIV status has also prevented support from the society. Experiencing discrimination and breach of confidentiality by health staff was less common, but probably spread out. No barrier from family was found towards infected individuals.

Conclusions

Interventions to promote timely initiation of care after diagnosis required understanding interaction of factors at multi-level in local context. Training for health staff should be enhanced. In addition, it’s necessary to mobilize community in the strategy against HIV stigma and discrimination.

KEYWORDS:

• ART
• barrier
• HIV care and treatment
• PLHIV
• Treat all policy‌

Disclosure statement

No potential conflict of interest was reported by the author(s).