HIV/AIDS; antiretroviral therapy (ART); access to HIV care and treatment; gender; poverty; stigma; social exclusion; equity
Gari Sara, Doig-Acuna Camilo, Smail Tino, Musheke Maurice, Malungo Jacob, Martin Hilber Adriane, Ntalasha Harriet, Merten Sonja (2013), A systematic review of socio-cultural barriers to access HIV/AIDS services., in BMC Health Services Research
, 13(1), 198.
Musheke Maurice, Bond Virginia, Merten Sonja (2013), Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in urban Zambia: Implications for HIV treatment programmes., in AIDS Research and Therapy
, 13(1), 12.
Musheke Maurice, Bond Virginia, Merten Sonja (2013), Couple experiences of provider-initiated couple HIV testing in an antenatal clinic in Lusaka, Zambia: lessons for policy and practice., in BMC Health Serv Res
, 13, 97.
Musheke Maurice, Ntalasha Harriet, Gari Sara, McKenzie Oran, Bond Virginia, Martin Hilber Adriane, Merten Sonja (2013), A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa., in BMC Public Health
, 13, 220.
Musheke Maurice, Bond Virginia, Merten Sonja (2012), Individual and contextual factors influencing patient attrition from antiretroviral therapy care in an urban community of Lusaka, Zambia, in J Int AIDS Soc
, 2012(15 Supp 1), 1-9.
Merten Sonja, Kenter Elise, McKenzie Oran, McKenzie Oran, Musheke Maurice, Ntalasha Harriet, Martin Hilber Adriane (2010), Patient-reported barriers and drivers of adherence to antiretrovirals in sub-Saharan Africa: a meta-ethnography, in Trop Med Int Health
, 2010(15 Suppl 1), 16-33.
Musheke Maurice, Bond Virginia, Merten Sonja, Deterrents to HIV-Patient Initiation of Antiretroviral Therapy in Urban Lusaka, Zambia: A Qualitative Study., in AIDS Patient Care STDS
Gari Sara, Musheke Maurice, Malungo Jacob, Schindler Christian, Merten Sonja, HIV testing and tolerance to gender violence: a cross-sectional study in Zambia, in PLOS One
Background: HIV/AIDS continues to pose a tremendous burden on Sub-Saharan Africa. Zambia is a high prevalence country, with a generalized epidemic, where large-scale antiretroviral programs were successfully introduced and are currently universally available to those that qualify. Antiretroviral therapy (ART) has been shown to improve sur-vival and subjective wellbeing of people with HIV. However, still many persons do not access HIV related services, and up to one third who is treated with antiretrovirals drops out of the programs.Access to HIV related therapy is a multifaceted problem. Factors limiting access range from difficulties in making ART available in remote areas, to asymmetrical entitlements to financial resources for accessing treatment within communities and households, even if medication is free, and to socio-cultural norms that create barriers to HIV test-ing and to antiretroviral therapy. Particularly anticipated stigma is powerful as a force preventing people living with HIV from accessing a range of services. While single topics such as gender and stigma associated with HIV have been studied, how it contributes to a broader concept of powerlessness and exclusion, and how that translates into generalized insecurity and vulnerability that underlies poor adherence and lacking access to care has yet to be investigated in a multidisciplinary way. This study addresses this gap.Research objective: to gain policy relevant insights in the dynamics influencing treatment seeking behavior related to HIV/AIDS at the community level.Methods: In a rural and an urban area of Zambia (Monze and Lusaka) a mixed-methods study will be carried out. In a first exploratory phase a focused ethnographic study will be conducted in each site, including key informant and in-depth interviews and focus group discussions with different subgroups. In a second phase the results of this study will inform a survey questionnaire where factors influencing access to HIV related services are investigated in a community based sample including 2880 individuals. The analysis will focus on the relationship between poverty, powerlessness and exclusion with sociocultural processes such as stigmatization as they underlie access to care.Expected relevance of the project: Clarification of the relevance of power imbalances, structural exclusion, sociocul-tural norms and an individual’s bargaining power as explanation for decision-making around health care options. An analysis of external and internal factors as well as norms and values, expectations about outcomes all of which affect individual health decision making regarding HIV related treatment seeking will be of both practical and theoretical relevance. Capacity building will be evidence based, multi-disciplinary and address researchers as well as local pro-gram leaders and health professionals.Partnership: This project was planned jointly by the different partners in preceding meetings in Lusaka with full attention to the KFPE principals of Research partnership. The research partnership of ISPM Basel and Bern with the Department of Social Development studies of the University of Zambia, with the Centre for Infectious Disease Re-search of Zambia (CIDRZ) and with ZAMBART (Zambia AIDS related TB) Project brings researchers and profes-sionals from clinical, public health and social sciences together, who are committed to work across their disciplines in order to improve access to HIV related care.