Lost to follow up: the (non)psychosocial barriers to HIV/AIDS care in southeast Nigeria

Medication withdrawal remains a problem in Nigeria's HIV care. The Enugu state of southeast Nigeria has 3,736 people living with HIV/AIDS (PLHIV), with a 1.9% HIV-positive prevalence rate among the age band of 15-49 years, higher than 1.3%, the national average for the same cohort. Despite the...

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Bibliographic Details
Published inAIDS care Vol. 36; no. 7; p. 908
Main Authors Uzim, Elochukwu Ernest, Lee, Po-Han
Format Journal Article
LanguageEnglish
Published England 02.07.2024
Subjects
Adolescent
Adult
Anti-HIV Agents - therapeutic use
COVID-19 - epidemiology
COVID-19 - psychology
Female
Focus Groups
Health Services Accessibility
HIV Infections - epidemiology
HIV Infections - psychology
HIV Infections - therapy
Humans
Interviews as Topic
Lost to Follow-Up
Male
Medication Adherence - psychology
Middle Aged
Nigeria - epidemiology
Qualitative Research
SARS-CoV-2
Social Stigma
Young Adult
Nigeria
stigma
people living with HIV/AIDS
medication adherence
psychosocial health
Nigeria
Antiretroviral therapy
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Summary:Medication withdrawal remains a problem in Nigeria's HIV care. The Enugu state of southeast Nigeria has 3,736 people living with HIV/AIDS (PLHIV), with a 1.9% HIV-positive prevalence rate among the age band of 15-49 years, higher than 1.3%, the national average for the same cohort. Despite the disease burden, many cases are "lost to follow-up" in this region. Through four focus groups of patients (20 participants in total) and in-depth interviews with four clinicians from four public hospitals, this study aimed to understand the barriers to attending healthcare appointments faced by young adults. The participants were recruited through flyers, posters, and snowballs at clinics; both data sets were first analysed separately yet used to triangulate each other. We found that clinical interruptions are mainly attributable to factors such as stigma, suicidal ideation, loss of means of livelihood due to PLHIV's "new identities", and thus poverty and malnutrition. These barriers, complicated by the COVID-19 pandemic and armed conflicts in the region, have made medication adherence further challenging. Therefore, we recommend the Nigerian government integrate non-biomedical support for PLHIV into people-centred HIV care.
ISSN:1360-0451
DOI:10.1080/09540121.2023.2253507