Experiences, Challenges, and Needs of People Living with HIV in Hunan Province, China: A Qualitative Study

Globally, the human immunodeficiency virus (HIV) epidemic continues to pose significant challenges. In China, the differentiated services delivery (DSD) model has been implemented to improve healthcare for people living with HIV (PLHIV). However, challenges persist in fully implementing and scaling up the DSD model. Given the knowledge gaps and the need for better strategies to support this vulnerable population, our study aimed to explore the experiences, challenges, and needs of PLHIV to inform the development of patient-centered healthcare services.

We employed a qualitative design to interview 20 PLHIV from July 27 to October 13, 2024, in the Infectious Disease Ward at the Second People's Hospital in Chenzhou, Hunan Province. Individual face-to-face in-depth interviews were conducted to collect data. Colaizzi's seven-step analysis method and NVivo 14 was used to analyze the transcripts.

The participants, aged 23 to 83 years, had been living with HIV for durations ranging from one month to 19 years. The interview data revealed four themes: (1) the physiological dimension: multi-organ physical symptoms, increased physical vulnerability, and a desire for healthcare guidance; (2) the psychological dimension: emotional distress, inadequate HIV-related knowledge, considerable stigma and discrimination, and a desire for respect and dignity; (3) the societal dimension: huge economic burden, fragile social networks, and a desire for social support; and (4) the spiritual dimension: mixed feelings about death, negative expectations of the future, seeking solace in faith, and a desire for a "good" death.

PLHIV in this study have undergone complex journeys across physical, psychological, societal, and spiritual dimensions, expressing urgent needs for support from various stakeholders. Our findings highlight the urgency of implementing patient-centered care, enhancing psychological support, reducing discrimination, and providing robust social and spiritual care through stakeholder collaboration to optimize the DSD model and resource allocation.