HIV/AIDS: Research and Palliative Care (Oct 2023)
Barriers and Facilitators to Utilization of Community Drug Distribution Points Among People Living with HIV in Bushenyi District, South-Western Uganda: A Qualitative Study
Abstract
David Oyet,1 Vallence Niyonzima,1 Gideon Akol,2 Emmanuel Onyait,1 Daphine Twinomugisha,3 Doreen Kawala Wambera,4 Edith K Wakida,5,6 Celestino Obua7 1Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda; 2Department of Medical Laboratory Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda; 3Department of Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda; 4Department of Physiotherapy, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda; 5Department of Medical Education, California University of Science and Medicine, Colton, CA, USA; 6Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda; 7Mbarara University of Science and Technology, Mbarara City, UgandaCorrespondence: Vallence Niyonzima, Department of Nursing, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara City, Uganda, Tel +256777842830, Email [email protected]: People living with HIV (PLHIV) still have challenges in accessing HIV services in low- and middle-income countries (LMIC). In Uganda, community drug distribution points (CDDPs) are part of interventions to improve access to anti-retroviral medications. However, there is still low enrollment in CDDPs among PLHIV in south-western Uganda, particularly in Bushenyi district. This study explored the barriers and facilitators to the utilization of CDDPs among PLHIV.Methods: This was a descriptive qualitative study utilizing a qualitative approach. We purposively recruited 24 PLHIV and 6 Primary healthcare providers as key informants. We conducted in-depth interviews with PLHIV and key informant interviews with Primary healthcare providers using an interview guide. The audio recordings were transcribed verbatim to Rukiga-Runyankore and then translated into English. Data were coded and analyzed using thematic analysis.Results: Seven themes were developed describing drivers for the utilization of CDDPs. These were broadly categorized into facilitators and barriers. The main facilitators of the utilization of CDDPs were peer support, positive Primary healthcare providers’ attitudes, satisfaction with HIV services, and accessibility of ART services. The main barriers were stigma, lack of physical infrastructure, and lack of comprehensive services.Conclusion and Recommendation: Utilization of CDDPs is facilitated by accessibility and Primary healthcare providers’ attitude. Stigma is still a limitation to the utilization of HIV services. We recommend that Ministry of Health and other development partners should improve physical infrastructural facilities at the CDDP sites so that the privacy and confidentiality of the PLHIV are protected. Focus on interventions to eliminate stigma by Primary healthcare providers and other stakeholders at CDDP sites is urgently needed.Keywords: community drugs distribution points, barriers, facilitators, Southwestern Uganda, qualitative study, people living with HIV
