Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe : Patient perspective on burden of disease.

BACKGROUND

People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients' lived experiences and expectations is vital for designing responsive service-delivery models.

METHODS

A cross-sectional, descriptive, qualitative study was conducted at primary healthcare facilities in Harare, Zimbabwe. Semi-structured interviews were conducted with 20 adults diagnosed with both HIV infection and T2DM. The data were transcribed, translated (where necessary), and analyzed using thematic analysis.

RESULTS

Four overarching themes emerged: (1) fragmented versus integrated care (2), time and out-of-pocket expenses (3), healthcare provider attitudes and behaviours, and (4) unmet needs and expectations. Participants reported challenges, such as multiple appointments, financial burdens, lack of confidentiality, and limited counselling. Positive experiences included culturally competent care and integrated service delivery, where available.

CONCLUSION

Primary care services should be restructured to provide integrated, holistic, and patient-centered care for individuals with HIV and T2DM comorbidities. Health provider training, infrastructure development, and access to medication are key to improving the outcomes.