Journal Article Epublish
PubMed: 40490764 DOI: 10.1186/s12913-025-12949-6
Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe : Patient perspective on burden of disease.
BMC Health Serv Res 25(1):817
Authors: Rumbidzai Chireshe, Tawanda Manyangadze, Keshena Naidoo
Affiliations
- Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa.
- Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Mazisi Kunene Road, Glenwood, Durban, 4041, South Africa.
- Department of Geosciences, School of Geosciences, Disasters, and Development, Faculty of Sciences and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.
- Department of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Abstract
BACKGROUND
People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients' lived experiences and expectations is vital for designing responsive service-delivery models.
METHODS
A cross-sectional, descriptive, qualitative study was conducted at primary healthcare facilities in Harare, Zimbabwe. Semi-structured interviews were conducted with 20 adults diagnosed with both HIV infection and T2DM. The data were transcribed, translated (where necessary), and analyzed using thematic analysis.
RESULTS
Four overarching themes emerged: (1) fragmented versus integrated care (2), time and out-of-pocket expenses (3), healthcare provider attitudes and behaviours, and (4) unmet needs and expectations. Participants reported challenges, such as multiple appointments, financial burdens, lack of confidentiality, and limited counselling. Positive experiences included culturally competent care and integrated service delivery, where available.
CONCLUSION
Primary care services should be restructured to provide integrated, holistic, and patient-centered care for individuals with HIV and T2DM comorbidities. Health provider training, infrastructure development, and access to medication are key to improving the outcomes.
MeSH
Diabetes Mellitus, Multiple Chronic Conditions, Hiv, Morbidity, Cost Of Illness, Diabetes Mellitus, Type 2