Study of patients’ perceptions leads to stronger TB-HIV services in Bulawayo, Zimbabwe
The Health Services Department of the City of Bulawayo in Zimbabwe considers providing high-quality HIV and TB services a top priority and used a survey of patients' perceptions to help them develop these services further.
Dr Zanele Hwalima of the City of Bulawayo collaborated with medical anthropologist Dr Alexander Rödlach of Creighton University (USA) and Dr Riitta Dlodlo of The Union, to explore patients' perceptions of HIV, AIDS and tuberculosis (TB) among persons taking antiretroviral treatment at two municipal clinics . Data were collected using the freelist technique to elicit the elements of a cultural domain, as well as open-ended interviews. Multidimensional scaling, hierarchical clustering and the grounded theory methods were used to analyse the data.
The findings suggested that the study respondents had substantial knowledge about HIV, AIDS and TB, though they had less information on TB than HIV-related issues. The importance of pregnant women knowing their HIV-status and enrolling into programmes to prevent mother-to-child HIV transmission were not widely appreciated. The participants were well aware of available treatment for both TB and HIV infection, and a diagnosis of HIV or TB alone was generally perceived with the hope that they would be able to live a normal life.
On the other hand, AIDS and TB-HIV co-infection were associated with death and despair — a negative perception that may delay or even prevent HIV-positive people who suspect they have AIDS or TB from seeking health care promptly. They may doubt that treatment can cure TB if a person has HIV infection.
As one outcome of this study, the Health Services Department has intensified the dissemination of basic facts about TB and the results of TB treatment in patients with and without HIV. This information also stresses the importance of persons contacting their closest clinic if for any reason they suspect they may have TB or HIV infection.
This study was published in the African Journal of AIDS Research:
Rödlach A, Dlodlo RA, Hwalima ZE. Perceptions of HIV, AIDS and tuberculosis among patients on antiretroviral therapy in Bulawayo, Zimbabwe: implications for the provision of HIV and TB care services. African Journal of AIDS Research 2012, 11(2): 99-112.
 Rödlach A, Dlodlo RA, Hwalima ZE. Perceptions of HIV, AIDS and tuberculosis among patients on antiretroviral therapy in Bulawayo, Zimbabwe: implications for the provision of HIV and TB care services. African Journal of AIDS Research 2012, 11(2): 99-112.