Journal of AIDS and HIV Research
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Article Number - E951A27836


Vol.1(2), pp. 034-043 , November 2009

ISSN: 2141-2359



Full Length Research Paper

Criteria used for selecting patients for antiretroviral therapy in Uganda: A qualitative study



Lydia Kapiriri
  • Lydia Kapiriri
  • Department of Health Aging and Society, McMaster University, Hamilton, ON, Canada L8S 4L8.
  • Google Scholar
Neema Sofaer
  • Neema Sofaer
  • Department of Primary Care and Social Medicine, Faculty of Medicine, Imperial College, London.
  • Google Scholar
Lynn M. Atuyambe
  • Lynn M. Atuyambe
  • Makerere University School of Public Health, Department of Community Health and Behavioural Sciences, Uganda.
  • Google Scholar
Erasmus Otolok-Tanga
  • Erasmus Otolok-Tanga
  • Makerere University School of Public Health, Department of Community Health and Behavioural Sciences, Uganda.
  • Google Scholar
Ole Frithjof Norheim
  • Ole Frithjof Norheim
  • Division for Medical Ethics, Institute of Public Health and the Centre for International Health, University of Bergen, Norway.
  • Google Scholar







 Accepted: 16 October 2009  Published: 30 November 2009

Copyright © 2009 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0


Limited resources in low income countries still prevent HIV patients from accessing treatment and necessitate the rationing of anti retroviral therapy. This paper aims to describe the criteria used in actual patient selection so as to develop evidence based recommendations for improving fairness in patient selection in Uganda and similar contexts. Qualitative interviews (n = 37) from six AIDS treatment units in Uganda; review of policy and clinic documents; and group discussions (n = 47) people living with AIDS. Practitioners identified both medical criteria (need, CD4 count, WHO staging, Absence of severe co-infections, patient readiness, and ART naivety) and social criteria (economic status, social support, treatment buddy, disclosure, duration with organization, distance, alcohol consumption, relatives of clients on ART, first-in- first- out, vulnerability and activism). There was congruence around the medical criteria across institutions and the national guidelines; and variations around the social criteria. The variations around the social criteria necessitate more explicit debate. Commonly used and accepted criteria could be considered for explicit inclusion in the national guidelines. Disputed criteria should be debated to identify an acceptable set of criteria for ART rationing. These criteria should be publicized to facilitate on-going revisions, ensure consistency, and contribute to fair patient selection.

 

Key words: HIV/AIDS, anti-retroviral treatment, Uganda, rationing, criteria.


APA (2009). Criteria used for selecting patients for antiretroviral therapy in Uganda: A qualitative study. Journal of AIDS and HIV Research, 1(2), 034-043.
Chicago Lydia Kapiriri, Neema Sofaer, Lynn M. Atuyambe, Erasmus Otolok-Tangaand Ole Frithjof Norheim. "Criteria used for selecting patients for antiretroviral therapy in Uganda: A qualitative study." Journal of AIDS and HIV Research 1, no. 2 (2009): 034-043.
MLA Lydia Kapiriri, et al. "Criteria used for selecting patients for antiretroviral therapy in Uganda: A qualitative study." Journal of AIDS and HIV Research 1.2 (2009): 034-043.
   
DOI
URL http://academicjournals.org/journal/JAHR/article-abstract/E951A27836

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