The experiences of patients with Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) co-infection in Rundu Namibia

Abstract

Namibia is one of the countries in Southern Africa which is hardest hit by the double burden of HIV and TB. Namibian national data shows that, although 50% of all TB patients in 2011 were HIV positive, there was an unintegrated approach in the management of these two diseases (Seeling, Mavhunga, Thomas, Adelberger & Ulrichs, 2014:269). It is against this background that this study was conducted. The goal of the study was to explore and describe the experiences of patients with HIV and TB co-infection in Rundu, Namibia. A qualitative research approach was utilised in this study. The researcher draws attention to the experiences of co-infected patients by employing a phenomenological design which allowed patients to reminisce on their lived experiences. The study was therefore exploratory and descriptive in scope. Unstructured one-on-one interviews were used to collect data. The findings reveal the presence of structural deficiencies in the management framework for co-infected patients. For instance, the multi-disciplinary team (MDT) was not well-co-ordinated and there was no integration of HIV and TB services. Consequently, patients experienced a sense of being neglected by health care professionals and noted that their interests as patients were, to a certain extent, ignored. Participants preferred to be treated in the context of their home environment by means of home based care (HBC). Most participants bemoaned the existence of stigma both at community level and in health care settings. A range of psychosocial experiences were also described. As a consequence of this study, general recommendations were put forward and these included the need for the Ministry of Health and Social Services (MoHSS) to expedite the integration of HIV and TB services in Namibia, particularly in relation to patients getting HIV and TB services under one roof. It was also noted that for co-infected patients to be holistically managed, there is a need to strengthen HBC as a strategy of managing patients to guarantee the involvement of family members in keeping with the biopsychosocial perspective (BPS), the theoretical framework for this study. While the goal and objectives of this study were generally met, the researcher stressed the need for future research to explore the feasibility of HBC as a strategy for managing HIV and TB co-infected patients before the Government of the Republic of Namibia could incorporate the strategy in policy.