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The co-management of HIV and chronic non-communicable diseases in the Dominican Republic: A qualitative study

Author

Listed:
  • Deshira D Wallace
  • Amarilis Then-Paulino
  • Gipsy Jiménez Paulino
  • Flabia Tejada Castro
  • Stephanie Daniela Castro
  • Kartika Palar
  • Kathryn P Derose

Abstract

People living with HIV and a non-communicable disease (NCD) experience multi-level barriers when co-managing multiple conditions. We explored the factors affecting living with multiple chronic conditions in the Dominican Republic. We conducted 21 in-depth interviews from October 2019-February 2020 with Dominican adults who participated in a food security intervention and managed HIV and at least one chronic NCD. Using thematic analysis, we explored participant lived experiences co-managing multiple chronic conditions. All participants (mean age = 45.5 years) were linked to HIV care, but only three were linked to NCD-specific care. Individual-level barriers to managing NCDs included limited education and limited self-efficacy for self-management. Interpersonally, barriers included limited rapport building with an NCD-specific specialist. Structural barriers to managing NCDs were no health insurance, poor referral systems, and limited financial assistance. Health system adaptation requires equitably considering the needs of individuals managing multiple chronic conditions. Key factors to address include patient-provider relationships, improved referral systems, accessibility and availability of specialists, and financial assistance.

Suggested Citation

  • Deshira D Wallace & Amarilis Then-Paulino & Gipsy Jiménez Paulino & Flabia Tejada Castro & Stephanie Daniela Castro & Kartika Palar & Kathryn P Derose, 2023. "The co-management of HIV and chronic non-communicable diseases in the Dominican Republic: A qualitative study," PLOS ONE, Public Library of Science, vol. 18(7), pages 1-17, July.
    • Handle: RePEc:plo:pone00:0288583
    DOI: 10.1371/journal.pone.0288583
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    References listed on IDEAS

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    1. Kathryn P Derose & Denise D Payán & María Altagracia Fulcar & Sergio Terrero & Ramón Acevedo & Hugo Farías & Kartika Palar, 2017. "Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-19, July.
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