The co-management of HIV and chronic non-communicable diseases in the Dominican Republic: A qualitative study
People living with HIV and a non-communicable disease (NCD) experience multi-level barriers when co-managing multiple conditions. We explored the factors affecting living with multiple chronic conditions in the Dominican Republic. We conducted 21 in-depth interviews from October 2019-February 2020 w...
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| Veröffentlicht in: | PloS one 2023-07, Vol.18 (7), p.e0288583-e0288583 |
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| creator | Wallace, Deshira D Then-Paulino, Amarilis Jiménez Paulino, Gipsy Tejada Castro, Flabia Castro, Stephanie Daniela Palar, Kartika Derose, Kathryn P |
| description | People living with HIV and a non-communicable disease (NCD) experience multi-level barriers when co-managing multiple conditions. We explored the factors affecting living with multiple chronic conditions in the Dominican Republic. We conducted 21 in-depth interviews from October 2019-February 2020 with Dominican adults who participated in a food security intervention and managed HIV and at least one chronic NCD. Using thematic analysis, we explored participant lived experiences co-managing multiple chronic conditions. All participants (mean age = 45.5 years) were linked to HIV care, but only three were linked to NCD-specific care. Individual-level barriers to managing NCDs included limited education and limited self-efficacy for self-management. Interpersonally, barriers included limited rapport building with an NCD-specific specialist. Structural barriers to managing NCDs were no health insurance, poor referral systems, and limited financial assistance. Health system adaptation requires equitably considering the needs of individuals managing multiple chronic conditions. Key factors to address include patient-provider relationships, improved referral systems, accessibility and availability of specialists, and financial assistance. |
| doi_str_mv | 10.1371/journal.pone.0288583 |
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We explored the factors affecting living with multiple chronic conditions in the Dominican Republic. We conducted 21 in-depth interviews from October 2019-February 2020 with Dominican adults who participated in a food security intervention and managed HIV and at least one chronic NCD. Using thematic analysis, we explored participant lived experiences co-managing multiple chronic conditions. All participants (mean age = 45.5 years) were linked to HIV care, but only three were linked to NCD-specific care. Individual-level barriers to managing NCDs included limited education and limited self-efficacy for self-management. Interpersonally, barriers included limited rapport building with an NCD-specific specialist. Structural barriers to managing NCDs were no health insurance, poor referral systems, and limited financial assistance. Health system adaptation requires equitably considering the needs of individuals managing multiple chronic conditions. Key factors to address include patient-provider relationships, improved referral systems, accessibility and availability of specialists, and financial assistance.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0288583</identifier><identifier>PMID: 37440525</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Adult ; AIDS ; Biology and Life Sciences ; Care and treatment ; Chronic conditions ; Chronic diseases ; Chronic illnesses ; Consent ; Data collection ; Diabetes ; Diagnosis ; Dominican Republic ; Food ; Food security ; HIV ; HIV (Viruses) ; HIV Infections - epidemiology ; HIV Infections - therapy ; Human immunodeficiency virus ; Humans ; Hyperlipidemia ; Hypertension ; Infectious diseases ; Interviews ; Medical diagnosis ; Medicine and Health Sciences ; Middle Aged ; Multiple Chronic Conditions ; Noncommunicable Diseases - epidemiology ; Noncommunicable Diseases - therapy ; Nutrition therapy ; Patient compliance ; Patient outcomes ; People and places ; Persistent Infection ; Public health ; Qualitative Research ; Risk factors ; Social Sciences</subject><ispartof>PloS one, 2023-07, Vol.18 (7), p.e0288583-e0288583</ispartof><rights>Copyright: © 2023 Wallace et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Wallace et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Wallace et al 2023 Wallace et al</rights><rights>2023 Wallace et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-5f6197f1fe5c90f4b48b354dc47ba7a161361fbdde064cc767ea75d139ed28d33</citedby><cites>FETCH-LOGICAL-c623t-5f6197f1fe5c90f4b48b354dc47ba7a161361fbdde064cc767ea75d139ed28d33</cites><orcidid>0000-0003-1300-6957</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343047/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343047/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2101,2927,23865,27923,27924,53790,53792,79471,79472</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37440525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Mao, Wenhui</contributor><creatorcontrib>Wallace, Deshira D</creatorcontrib><creatorcontrib>Then-Paulino, Amarilis</creatorcontrib><creatorcontrib>Jiménez Paulino, Gipsy</creatorcontrib><creatorcontrib>Tejada Castro, Flabia</creatorcontrib><creatorcontrib>Castro, Stephanie Daniela</creatorcontrib><creatorcontrib>Palar, Kartika</creatorcontrib><creatorcontrib>Derose, Kathryn P</creatorcontrib><title>The co-management of HIV and chronic non-communicable diseases in the Dominican Republic: A qualitative study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>People living with HIV and a non-communicable disease (NCD) experience multi-level barriers when co-managing multiple conditions. 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Key factors to address include patient-provider relationships, improved referral systems, accessibility and availability of specialists, and financial assistance.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>AIDS</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Chronic conditions</subject><subject>Chronic diseases</subject><subject>Chronic illnesses</subject><subject>Consent</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diagnosis</subject><subject>Dominican Republic</subject><subject>Food</subject><subject>Food security</subject><subject>HIV</subject><subject>HIV (Viruses)</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Hypertension</subject><subject>Infectious diseases</subject><subject>Interviews</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Multiple Chronic Conditions</subject><subject>Noncommunicable Diseases - 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We explored the factors affecting living with multiple chronic conditions in the Dominican Republic. We conducted 21 in-depth interviews from October 2019-February 2020 with Dominican adults who participated in a food security intervention and managed HIV and at least one chronic NCD. Using thematic analysis, we explored participant lived experiences co-managing multiple chronic conditions. All participants (mean age = 45.5 years) were linked to HIV care, but only three were linked to NCD-specific care. Individual-level barriers to managing NCDs included limited education and limited self-efficacy for self-management. Interpersonally, barriers included limited rapport building with an NCD-specific specialist. Structural barriers to managing NCDs were no health insurance, poor referral systems, and limited financial assistance. Health system adaptation requires equitably considering the needs of individuals managing multiple chronic conditions. Key factors to address include patient-provider relationships, improved referral systems, accessibility and availability of specialists, and financial assistance.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37440525</pmid><doi>10.1371/journal.pone.0288583</doi><tpages>e0288583</tpages><orcidid>https://orcid.org/0000-0003-1300-6957</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Adult AIDS Biology and Life Sciences Care and treatment Chronic conditions Chronic diseases Chronic illnesses Consent Data collection Diabetes Diagnosis Dominican Republic Food Food security HIV HIV (Viruses) HIV Infections - epidemiology HIV Infections - therapy Human immunodeficiency virus Humans Hyperlipidemia Hypertension Infectious diseases Interviews Medical diagnosis Medicine and Health Sciences Middle Aged Multiple Chronic Conditions Noncommunicable Diseases - epidemiology Noncommunicable Diseases - therapy Nutrition therapy Patient compliance Patient outcomes People and places Persistent Infection Public health Qualitative Research Risk factors Social Sciences |
| title | The co-management of HIV and chronic non-communicable diseases in the Dominican Republic: A qualitative study |
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