Background
Methods
Information sources and search strategy
HIV | AND | Satisf* | NEAR/5 | Care |
Aspect* | Healthcare | |||
View* | service* | |||
Perception* | provider* | |||
Perceive* | ||||
Attitude* | ||||
Experience* | ||||
Belief* | ||||
Evaluat* | ||||
Value* | ||||
Prefer* |
Eligibility and study selection
Inclusion criteria | A primary aim of the paper/element of the results was to explore which aspects of health care are valued by people living with HIV |
Data collected during the era of combination antiretroviral therapy (ART) (from 1996 onwards) | |
Quantitative or qualitative methodology | |
Written in English | |
Published in a peer-reviewed journal or conference abstract | |
Exclusion criteria | Based on data collected prior to the introduction of combination ART (1996) |
Did not contain any primary data (e.g. review articles, editorials) | |
Conference abstract without extractable data | |
Research conducted outside of UK/Europe/USA/Canada/Australia/New Zealand | |
Patients were children/adolescents | |
Focus on dental care | |
Focus on HIV care during pregnancy | |
Focus on HIV testing services | |
Focus on end of life care | |
Focus on barriers to service entry | |
Focus on inpatient services. |
Data extraction
Quality assessment
First author/year | Type of study | Screening questions | Qualitative | Quantitative descriptive | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Are there clear qualitative or quantitative research questions, or a clear mixed methods research question? | Do the data collected address the research question? | 1.1 Are the sources of qualitative data relevant to address the research question? | 1.2 Is the process for analysing qualitative data relevant to address research question? | 1.3 Is appropriate consideration given to how findings relate to the context in which data were collected? | 1.4 Is appropriate consideration given to how findings relate to researchers’ influence through interaction with participants? | 4.1 Is the sampling strategy relevant to address the research question? | 4.2 Is the sample representative of the population under study? | 4.3 Are measurements appropriate (clear origin, or validity known, or standard instrument)? | 4.4 Is there an acceptable response rate (60% or above?) | ||
Allan (2005) [20] | Qualitative** | Yes | Yes | Can’t tell | Yes | Yes | Can’t tell | - | - | - | - |
Baker (2014) [18] | Quantitative** | Yes | Yes | - | - | - | - | Yes | Can’t tell | Yes | Can’t tell |
Bennett (2014) [27] | Qualitative** | Yes | Yes | Yes | Yes | Can’t tell | Can’t tell | - | - | - | - |
Bodenlos (2004) [34] | Quantitative**** | Yes | Yes | - | - | - | - | Yes | Yes | Yes | Yes |
Dang (2012) [12] | Quantitative**** | Yes | Yes | - | - | - | - | Yes | Yes | Yes | Yes |
Davis-Michaud (2004) [22] | Mixed* | Yes | Yes | No | Yes | Can’t tell | Can’t tell | Can’t tell | No | Yes | Can’t tell |
Dawson-Rose (2005) [21] | Qualitative*** | Yes | Yes | Yes | Yes | Yes | Can’t tell | - | - | - | - |
Emlet (2002) [30] | Quantitative*** | Yes | Yes | - | - | - | - | Yes | Yes | Yes | No |
Harrison (2009) [31] | Quantitative* | Yes | Yes | - | - | - | - | Can’t tell | Can’t tell | Yes | Can’t tell |
Hekkink (2003) [23] | Mixed*** | Yes | Yes | Yes | Yes | Can’t tell | Can’t tell | Yes | Yes | Yes | No |
Hekkink (2005) [32] | Quantitative**** | Yes | Yes | - | - | - | - | Yes | Yes | Yes | Yes |
Hope (2001) [33] | Quantitative*** | Yes | Yes | - | - | - | - | Yes | Can’t tell | Yes | Yes |
Laschinger (2005) [24] | Qualitative** | Yes | Yes | Can’t tell | Yes | Can’t tell | Can’t tell | - | - | - | - |
Mallinson (2007) [25] | Qualitative**** | Yes | Yes | Yes | Yes | Yes | Can’t tell | - | - | - | - |
McCoy (2005) [26] | Qualitative**** | Yes | Yes | Yes | Yes | Yes | Yes | - | - | - | - |
Moore (2010) [15] | Mixed** | Yes | Yes | Yes | Yes | Can’t tell | Can’t tell | Can’t tell | No | Yes | Yes |
Ndirangu (2009) [16] | Qualitative*** | Yes | Yes | Yes | Yes | Can’t tell | Can’t tell | - | - | - | - |
Pollard (2015) [29] | Qualitative*** | Yes | Yes | Yes | Yes | Yes | Can’t tell | - | - | - | - |
Sullivan (2000) [35] | Quantitative**** | Yes | Yes | - | - | - | Yes | Yes | Yes | Yes | |
Tsasis (2010) | Quantitative** | Yes | Yes | - | - | - | - | Yes | Can’t tell | Can’t tell | Yes |
Vyavaharkar (2008) [17] | Qualitative*** | Yes | Yes | Yes | Yes | Yes | Can’t tell | - | - | - | - |
Williams (2011) [28] | Qualitative* | Yes | Yes | Yes | Can’t tell | Can’t tell | Can’t tell | - | - | - | - |
Zablosta (2009) | Quantitative** | Yes | Yes | - | - | - | - | Yes | Can’t tell | Yes | No |
Assessment of risk of bias across studies
Results
Study selection
Study characteristics
Study | Country | Aim relevant to this review | Methods | Service type | HIV+ Sample | N (HIV+) | Mean Age (Years) | Gender (% male) | Ethnicity |
---|---|---|---|---|---|---|---|---|---|
Allan & Clarke (2005) | UK | To determine whether existing HIV services in Leeds meet the needs of HIV-positive asylum seekers. | Qualitative: Interviews | GUM service | Asylum seekers | 14 | Not stated | Not stated | Not stated |
Baker et al. (2014) | USA | To analyse satisfaction with health care among African American women living with HIV/AIDS | Quantitative: Questionnaire | HIV outpatient clinic | African American women | 157 | 40 (SD 9) | 0 | 100% African American |
Bennett et al. (2014) | UK | To explore the experience and needs of people living with HIV who are accessing healthcare services. | Qualitative: Focus groups | Not stated | General | 16 | Not stated | 44 | Not stated |
Bodenlos et al. (2004) | USA | To develop and validate an instrument to measure patient attitudes toward Health Care Professionals in the HIV population. | Quantitative: Questionnaire | Outpatient clinic | General | 129 | 38 (median) (Range 18–61) | 57 | 83% African American 16% Caucasian 1% Hispanic |
Dang et al. (2012) | USA | To determine components which contribute to patients’ satisfaction with HIV care and the relative importance of each component. | Quantitative: Questionnaire | HIV outpatient service | General | 489 | 48 (SD 11) | 71 | 61% Non Hispanic Black 15% Non Hispanic White 21% Hispanic 3% Other |
Davis-Michaud et al. (2004) | USA | To explore patient preferences regarding HIV care. | Qualitative and quantitative: Focus groups and ranking exercise | Not specified | General | 29 | 41 (Range 26–60) | 69 | 25% African American 7% Latino 62% Caucasian 3% Asian 3% Native American |
Dawson-Rose et al. (2005) | USA | To identify barriers and facilitators to care among HIV positive injection drug users. | Qualitative: Interviews | Not specified | Injection drug users | 161 | 35 (SD 7) | 50 | 62 % African American 13% Latino 21% Caucasian 4% Mixed/Other |
Emlet & Berghuis (2002) | USA | To explore service use differences between younger and older persons with HIV/AIDS? | Quantitative: Questionnaire | Not specified | General (Divided into groups based on age) | 287 | Younger group 34 (SD 3.9) Older group 54 (SD 4.5) | Younger group 86 Older group 94 | Younger group 70% White 29% Non-white Older group 78% White 21% Non-white |
Harrison et al. (2009) | UK | To conduct a patient survey to help design a new HIV/Sexual Health service. | Quantitative: Questionnaire | HIV/sexual health outpatient clinic | General | 59 | Not stated | Not stated | 38% African |
Hekkink et al. (2003) | Netherlands | To develop and validate a questionnaire to measure the quality of HIV care from the patient’s perspective. | Qualitative and quantitative: Focus groups and questionnaire | Not specified | General | Focus groups 15 Questionnaire 44 | Focus groups 49 (Range 30–62) Questionnaire 43 (SD 7.6) | Focus groups 80 Questionnaire 84 | Not stated |
Hekkink et al. (2005) | Netherlands | To compare patients’ perceptions of the quality of HIV care received from nursing consultants, HIV specialists and GPs. | Quantitative: Questionnaire | GP and specialist HIV care | General | 153 | 44 (SD 7.4) | 90 | Not stated |
Hope et al. (2001) | UK | To collect data to inform the improvement of HIV/GUM services in West London. | Quantitative: Questionnaire | HIV/GUM outpatient clinic | General | 202 | 16 % ≤30 yrs 84 % > 30 yrs | 88 | 82% White 8% Black 6% Mixed race 3% Asian |
Laschinger et al. (2005) | Canada | To describe and compare perceptions of HIV care from the perspectives of patients and health care professionals. | Qualitative: Focus groups | HIV/mixed outpatient clinics | General | Not stated | Not stated | Not stated | Not stated |
Mallinson et al. (2007) | USA | To discover what specific provider behaviours influence engagement in HIV care from the client’s perspective. | Qualitative: Interviews | Community services/clinics | General | 76 | 39 (Range 19–58) | 51 | 51% African American 19% Hispanic 13% Mixed race 12% White/Caucasian 4% Native American 1% Asian |
McCoy (2005) | Canada | To explore HIV patients' perceptions of 'good doctoring'. | Qualitative: Interviews and focus groups | Community services/clinics | General | 79 | Early 20s to late 50s | 72 | Not stated |
Moore et al. (2010) | USA | To assess the value of the QUOTE-HIV questionnaire to identify African American patients’ perceptions of HIV care and further explore health care disparities in the HIV-positive African American population. | Qualitative and quantitative: Questionnaire and focus groups | Mixed | African-Americans | Questionnaire 55 Interviews 16 | Range 20-59 | 69 | 100% African American |
Pollard et al. (2015) | UK | To examine patients’ preferences for the future delivery of services | Qualitative: Focus groups | HIV outpatient clinic | General | 74 | Not stated | 61 | 41% White British 4% White other 41% Black African 7% Other Black 3% Mixed race |
Ndirangu & Evans (2009) | UK | To explore migrant African women's experiences of coping with HIV and their views about the HIV services. | Qualitative: Interviews | Hospital clinic/drop in centre | African women living in the UK | 8 | Range 30s-50 | 0 | 62% Zimbabwean 13% Congolese 25% Malawian |
Sullivan et al. (2000) | USA | To explore the extent to which various aspects of the doctor-patient relationship were associated with overall satisfaction with the doctor. | Quantitative: Two satisfaction questions | Outpatient clinic | General | 146 | 37 (SD 7.9) | 75 | 49% Black 21% Hispanic 30% White |
Tsasis et al. (2000) | Canada | To explore factors associated with satisfaction with HIV care. | Quantitative: Questionnaire | Outpatient clinic | General | 193 | Majority aged 30–49 years | 91 | Not stated |
Vyavaharkar et al. (2008) | USA | To explore the perceptions of the availability, accessibility, and quality of HIV health care and social services of African American women residing in rural South Carolina. | Qualitative: Focus groups | Not stated | African-American women | 22 | 44 (SD 9.2) | 0 | 100% African American |
Williams et al. (2011) | USA | To determine the barriers to and facilitators of consistently attending HIV medical care visits among a group of PLWH who had successfully negotiated enrolling in HIV care. | Qualitative: Focus groups | Public infectious disease clinic | General | 25 | 40 (Range 24–54) | 60 | 84% African American |
Zablotska et al. (2009) | Australia | To explore service needs of gay men living with HIV and any barriers to accessing them. | Quantitative: Questionnaire | Mixed (GP/outpatient services/sexual health clinics) | Men who have sex with men | 270 | 46 (median) (Range 26–72) | 100 | Not stated |
Quality assessment
Data synthesis
1. Relationship with health care provider
2. Expertise of the healthcare provider
3. Access to healthcare
4. Provision of information and support
5. Good communication between services
6. Factors relating to confidentiality and stigma
7. Patient involvement in healthcare
The relative importance of different aspects of care
Study | Measure Used | Most Valued Aspects of Care |
---|---|---|
Dang et al. (2012) | Developed a 22-item questionnaire based on validated tools, exploring perceptions of various aspects of the care provided and overall satisfaction. | The aspects of care most strongly associated with overall satisfaction were: 1) Satisfaction with the HIV provider (e.g. doctor, nurse) 2) Facility environment (e.g. noise, cleanliness) 3) Ease of calling the clinic and getting answers 4) Clinic staff (e.g. receptionist) |
Davis-Michaud et al. (2004) | Participants were given 18 attributes of care on cards and asked to sort into piles according to the level of importance. | The most important factors: 1) Relationship with care providers 2) Prevention of opportunistic infections 3) Involvement in care and treatment decisions 4) Being offered ART |
Hekkink et al. (2003) | QUOTE-HIV – participants rated the importance of 27 aspects of HIV care delivered by GPs, specialist doctors and nurse consultants. | Most important aspects of care: Specialists 1) Have special knowledge of HIV 2) Give information about possible side effects of drugs 3) Inform me about the pros and cons of a treatment 4) Give information about the use of my HIV medication GPs 1) Take me seriously 2) Maintain confidentiality about my HIV status 3) Take my opinion into account 4) Inform me about the pros and cons of a treatment HIV Consultant Nurse 1) Have special knowledge of HIV 2) Take me seriously 3) Give information about the use of my HIV medication 4) Maintain confidentiality about my HIV status |
Hekkink et al. (2005) | QUOTE-HIV – participants rated the importance of 27 aspects of care received from HIV nurse consultant. | Aspects of care rated most important: 1) Has special knowledge about HIV 2) Takes me seriously 3) Maintains confidentiality about my HIV status 4) Can easily be reached by phone |
Hope et al. (2001) | A questionnaire was developed for the study assessing the importance of a range of service attributes. | Aspects of care rated as ‘essential’ by >75% participants: 1) Treatment by specialists 2) Up-to-date treatment 3) Caring clinic 4) Individual requirements 5) Efficient outpatient service 6) Walk in service |
Moore et al. (2010) | QUOTE-HIV – participants rated the importance of the various aspects of care they receive from their specialist. | Aspects of care rated most important: 1) Provides an explanation, in language that I can understand, concerning prescribed medicines 2) Tells me what the possible side effects of a medicine are 3) Provides information about how I should take the prescribed HIV medication 4) Includes me in decision making regarding the treatment that I receive |