Factors blocking the good care of people living with HIV in madagascar
International Journal of Development Research
Factors blocking the good care of people living with HIV in madagascar
Received 20th January, 2021; Received in revised form 14th February, 2021; Accepted 06th March, 2021; Published online 13th April, 2021
Copyright © 2021, Niaina Zakaria Rodolphe Andriamifidison et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This study consists of identifying the problems of care for people living with HIV (PLHIV). This is a cross-sectional, descriptive and retrospective study including all referring doctors. The median age was 51 years with a sex ratio of 1. The median year of specific HIV training was 10 years. Each doctor takes care of an average of 34.7 PLHIV [range: 0-320], 94% of the 903 PLHIV followed were on first-line treatment. Stock-outs of first-line molecules were the most frequent cause of change in treatment regimen by 50% of physicians. The other causes were the occurrence of side effects (42%), confirmed (30.8%) or suspected (23%) resistance. The lack of means of virological and immune monitoring was found in 84.5% of physicians. The problems in the management of the main opportunistic infections apart from tuberculosis were the lack of means of biological diagnostics (84.5%), the difficulties of access to imaging (57.5%) and the absence of reference drugs in more than 70% of cases. The training of referring physicians is not regular. They encounter a lot of difficulties and their training by experts and the sharing of experiences between them would be a solution to help them improve the care of PLHIV.
