Understanding barriers to HIV care and treatment adherence in Guyana and the Caribbean: A mixed-methods analysis

IF 1.7 Q4 INFECTIOUS DISEASES

IJID regions Pub Date : 2025-09-10 DOI:10.1016/j.ijregi.2025.100744

Tariq Jagnarine

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Abstract

Objectives

This study aimed to identify and analyze the primary barriers to HIV care and treatment adherence in Guyana and the Caribbean.

Methods

A cross-sectional mixed-methods design was employed, incorporating quantitative surveys and qualitative interviews with 200 HIV-positive individuals attending clinics in Guyana and the Caribbean. The data were analyzed using both descriptive and inferential statistics. Ethical approval was obtained.

Results

Key findings revealed that stigma (60%), financial constraints (55%), and transportation issues (45%) were the most reported barriers. Stigma was particularly prevalent among unemployed participants (P <0.05), while transportation challenges were more significant in rural areas (P <0.01). Approximately 85% of participants reported adherence rates above 90%, but 15% had discontinued treatment due to side effects, stigma, or financial barriers. Follow-up support, such as peer counseling, significantly improved re-engagement in care (P <0.01).

Conclusions

The study highlights the multifaceted barriers to HIV care in Guyana and the Caribbean, emphasizing the urgent need for targeted interventions to reduce stigma, improve financial accessibility, and enhance follow-up services.

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了解圭亚那和加勒比地区艾滋病毒护理和治疗坚持的障碍：一项混合方法分析

本研究旨在确定和分析圭亚那和加勒比地区艾滋病毒护理和治疗依从性的主要障碍。方法采用横断面混合方法设计，对圭亚那和加勒比地区就诊的200名艾滋病毒阳性个体进行定量调查和定性访谈。使用描述性和推断性统计对数据进行分析。获得伦理批准。结果主要调查结果显示，耻辱感（60%）、财务限制（55%）和交通问题（45%）是报告最多的障碍。耻辱感在失业参与者中尤为普遍（P <0.05），而交通挑战在农村地区更为显著（P <0.01）。大约85%的参与者报告依从率超过90%，但15%的参与者因副作用、耻辱感或经济障碍而停止治疗。随访支持，如同伴咨询，显著提高了护理的再参与（P <0.01）。该研究强调了圭亚那和加勒比地区艾滋病毒护理的多方面障碍，强调迫切需要有针对性的干预措施，以减少耻辱感，改善经济可及性，并加强后续服务。

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