METHODS: We conducted in-depth interviews with OPLWH and focus group discussions with health care providers (HCPs) from 5 specialties (primary care medicine, psychological medicine, gynecology, geriatrics, and infectious disease) at a tertiary hospital between September 2021 and April 2022. All sessions were audio-recorded, transcribed verbatim, and analyzed thematically.
RESULTS: We recruited 16 OPLWH and 7 HCPs. Thirteen OPLWH were male. Eight of them self-identified as men who have sex with men, and the rest were heterosexual. Diagnosis of HIV was between the ages of 50 and 61 years. Barriers and facilitators could be categorized into 3 levels: individual, interpersonal, and institutional. Individual barriers included misinformation about HIV treatment, unable to afford HIV-related services, and belief that life was futile. Interpersonal barriers were HIV-related stigma, poor social and family support, and social prejudice toward men who have sex with men. Lastly, institutional barriers were the need for frequent hospital visits, high cost for HIV-related services, a lack of guidance after diagnosis, and poor communication with HCPs. Facilitators included doctor or friend support and positive institutional reputation.
CONCLUSIONS: Multiple challenges hindered optimal care for OPLWH after HIV diagnosis. Issues like high costs, belief that treatment is futile, and a lack of family support need to be addressed as part of long-term support services for OPLWH.
METHODS: 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience.
RESULTS: The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia.
CONCLUSION: Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.