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Perceived Barriers Toward Provider-Initiated HIV Testing and Counseling (PITC) in Pediatric Clinics: A Qualitative Study Involving Two Regional Hospitals in Dar-Es-Salaam, Tanzania

Authors Marwa R, Anaeli A

Received 23 October 2019

Accepted for publication 14 March 2020

Published 31 March 2020 Volume 2020:12 Pages 141—150

DOI https://doi.org/10.2147/HIV.S235818

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya


Rose Marwa, Amani Anaeli

Department of Public Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar-es- Salaam, Tanzania

Correspondence: Rose Marwa P.O. Box 78838, Dar-es-Salaam, Tanzania
Tel +255 716 482 348
Email rmarwa10@gmail.com

Background: According to Provider-Initiated HIV Testing and Counseling (PITC), healthcare providers recommend HIV testing and counseling to persons attending health care facilities as a standard component of medical care. In order to reduce the morbidity and mortality of late Human Immunodeficiency Virus (HIV) diagnosis, timely diagnosis and initiation of ARVs is necessary. This aims to accelerate universal access to HIV prevention, treatment, care, and support services for people living with HIV/AIDS. The present study aimed to explore perceived barriers toward PITC provision in pediatric clinics.
Methods: The study had a cross-sectional exploratory study design. In-depth interviews were used to collect data from the informants in Mwananyamala and Temeke hospitals in Dar-es-Salaam. Nineteen informants were recruited purposely for in-depth interviews. All the interviews were audio recorded, transcribed verbatim, and translated from Swahili to English. Lastly, data were analyzed using a thematic analysis approach.
Results: The study findings showed six barriers including inadequate training on PITC among healthcare providers, little practice of PITC provision, inability to properly counsel patients due to little knowledge, poor attitude of healthcare providers in providing PITC, shortage of healthcare providers, and little motivation and incentives among healthcare providers. Patient barriers included little understanding of PITC among parents/guardians of children and its importance in terms of their children’s health, absence of parents, overcrowding at clinics, HIV/AIDS stigma, lack of privacy at clinics, and harsh language of some of the healthcare providers. Health facility barriers included inadequate space to provide PITC and shortage of medical equipment and medical supplies for HIV testing. Policy-related barriers included the absence of PITC guidelines in each consultation room.
Conclusion: Perceived barriers toward PITC must be understood for effective implementation of PITC to reach 90-90-90 goal. The study identified several barriers which need to be addressed in order to improve PITC provision.

Keywords: pediatric clinics, HIV/AIDS, PITC, perceived barriers

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