Background:
Tuberculosis and HIV are among the infectious disease that is stigmatized in the community. In this study, we evaluate the effect of HIV-related stigma on pediatric TB diagnosis and treatment among caregivers.
Methods:
Forty-four in-depth interviews (IDIs) were conducted with caregivers of children under five years who have been investigated for TB and program managers coordinating TB activities. Focus group discussions were conducted with HCWs and community health workers supporting TB care services. Interviews records were transcribed and translated into the English language. A code list was developed using both deductive and inductive methods. Transcripts were coded and analyzed with MAXQDA v.12 using thematic analysis.
Results:
Predominantly in the community, many believe that TB is a disease strictly for adults and that when one has it, he/she automatically has HIV. Few caregivers reported TB treatment is an initial phase of HIV treatment. Some caregivers perceived TB treatment to be long and people in the community may confuse it with HIV treatment. Such beliefs initially led to the refusal of TB and HIV diagnosis and treatment abandonment. The majority of participants were aware of an association between TB and HIV. Few caregivers mentioned that some TB patients fear that they will receive another diagnosis adding to their existing condition. Many mentioned that the stigma doubles when one has both illnesses. Many also reported that this stigma contributes to the lack of support from family members.
Conclusion:
The results stress the need for cultural sensitive information to address the misconceptions and stigma surrounding TB and HIV. Furthermore, there is a need for an integrated approach in the fight against HIV and TB while recognizing the social connotation and interwind nature of the dual epidemic.