A socio-ecological analysis of factors influencing HIV treatment initiation and adherence among key populations in Papua New Guinea

Mitchell, Elke, Hakim, Avi, Nosi, Somu, Kupul, Martha, Boli-Neo, Ruthy, Aeno, Herick, Redman-MacLaren, Michelle, Ase, Sophie, Amos, Angelyn, Hou, Parker, Narokobi, Rebecca, Willie, Barne, Vallely, Andrew J., Kaldor, John M., Badman, Steven G., and Kelly-hanku, Angela (2021) A socio-ecological analysis of factors influencing HIV treatment initiation and adherence among key populations in Papua New Guinea. BMC Public Health, 21. 2003.

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Background: In Papua New Guinea (PNG) members of key populations, including female sex workers (FSW), men who have sex with men (MSM) and transgender women (TGW), have higher rates of HIV compared to the general adult population and low engagement in HIV care. This paper examines the socio-ecological factors that encourage or hinder HIV treatment initiation and adherence among HIV positive members of key populations in PNG.

Methods: As part of a larger biobehavioural survey of key populations in PNG, 111 semi-structured interviews were conducted with FSW, MSM and TGW, of whom 28 identified as living with HIV. Interviews from 28 HIV positive participants are used in this analysis of the influences that enabled or inhibited HIV treatment initiation and treatment adherence.

Results: Enablers included awareness of the biomedical benefits of treatment; experiences of the social, familial and health benefits of early treatment initiation and adherence; support provided by family and friends; and nonjudgmental and supportive HIV service provision. Factors that inhibited treatment initiation and adherence included perception of good health and denial of HIV diagnosis; poor family support following positive diagnosis; and anonymity and stigma concerns in HIV care services.

Conclusion: Exploring health promotion messages that highlight the positive health impacts of early treatment initiation and adherence; providing client-friendly services and community-based treatment initiation and supply; and rolling out HIV viral load testing across the country could improve health outcomes for these key populations.

Item ID: 69898
Item Type: Article (Research - C1)
ISSN: 1471-2458
Keywords: Papua New Guinea, HIV treatment, Key populations, Qualitative, Adherence, HIV care cascade
Copyright Information: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Sensitivity Note: Sensitive sexual health data
Date Deposited: 11 Nov 2021 02:58
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 100%
SEO Codes: 21 INDIGENOUS > 2111 Pacific Peoples health > 211101 Pacific Peoples determinants of health @ 100%
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