Related Experiment Video
Updated: Jan 8, 2026
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
A mixed-methods study on healthcare workers' perceptions of treatment adherence among HIV-TB co-infected patients in
Ruili Bi1, Lingwei Dou2,3, Rong Pei3
1School of Public Administration, China University of Geosciences, Wuhan, Hubei, China.
Background:
Integrated service models aim to improve HIV-tuberculosis (TB) comorbidity management, yet little is known about how frontline providers perceive adherence challenges under China's Integrated Prevention and Control of Four Diseases (IPC4D) policy. This mixed-methods study explored healthcare workers' assessments of adherence, perceived barriers, and policy effects in Liangshan Prefecture-a high-burden, resource-limited, multi-ethnic region.
Methods:
Between May and June 2025, an online survey of 492 healthcare workers and 30 in-depth interviews were conducted. Quantitative data were analyzed using descriptive statistics and ordinal logistic regression [odds ratios (ORs), 95% confidence intervals (CIs)]; qualitative data underwent thematic analysis.
Results:
Overall, 64.0% of respondents rated patient adherence as "good" or "very good," yet intermittent medication use (50.4%), unsupervised discontinuation (43.7%), and missed follow-ups (37.8%) remained common. Key perceived barriers included low health literacy (86.8%), regimen complexity (62.8%), side effects (61.2%), financial burden (59.8%), and limited family support (52.2%). Female respondents were less likely to report high adherence (OR = 0.57, 95% CI: 0.36-0.91), while clinicians (OR = 2.67, 95% CI: 1.35-5.31) and those in infectious disease departments (OR = 2.38, 95% CI: 1.23-4.64) reported more favorable assessments. Standardized adherence assessment correlated with lower reported adherence (OR = 0.16, 95% CI: 0.09-0.28), whereas institutional efforts to reduce financial burden were linked to higher adherence (OR = 1.78, 95% CI: 1.02-3.11). Qualitative findings highlighted persistent stigma, socioeconomic barriers, and mixed experiences with IPC4D implementation.
Conclusion:
Healthcare workers recognize IPC4D's value in improving coordination and access but report enduring multilevel barriers. Strengthening policy impact requires standardized adherence monitoring, socioeconomic support, workforce development, and culturally sensitive patient education.
Related Concept Videos
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:29Therapeutic Drug Monitoring: Affecting Factors
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...