Abstract

EVALUATION OF HIV-POSITIVE PATIENTS’ INVOLVEMENT IN HEALTHCARE DECISION MAKING IN EKITI STATE, NIGERIA

Ekene Pauline Anugha-Ugochukwu***, Kenneth Agu, Chinekwu Osondu***, Daniel Chinenyeike Offie*, Philip Imohi and Olajide Stephen Kolawole

ABSTRACT

Background: Poor involvement of People Living with HIV (PLHIV) in health care decisions can result in negative outcomes which delay the attainment of the UNAIDS 95-95-95- goal. This study aimed at assessing the perception of PLHIV on their involvement, preferences and factors that affect their involvement in decisions pertaining to their health. Methods: A cross-sectional survey was conducted among 423 patients living with HIV from the selected 7 treatment sites in Ekiti State, Nigeria. An adapted and pretested questionnaire from the nine-item Shared Decision-Making Questionnaire was used to collect the responses from participants. A simple random sampling was used to select the respondents. Data entries and analysis were done using SPSS version 24. Descriptive statistics was used to summarize quantitative variables while measures of association were done using Chi-square. Binary and multinomial logistic regression analysis were used to assess the effect of the significant factor on shared decision-making preference. A p-value<0.05 was considered statistically significant for the study. Results: 423 questionnaires were distributed while 91% (387) were returned. Findings revealed that 82.2% of the respondents agreed that their doctor introduced a need for decision making while 88.6% agreed that the doctor highlighted the pros and cons of treatment options. Regarding decision making preferences, 86.4% (232) preferred Shared Decision Making, whereas 10.9% (11) preferred to play a passive role during decision making by their doctor. Clients’ duration on Anti-Retroviral Therapy (ART) was found to be significantly associated (P = 0.028) with their preferences for SDM with their doctor. Time constraints (25%) and unfriendly consultation environment (15%) were highlighted as a discouraging factor while use of easy language by the doctor (10%) and availability of ART Differentiated Service Delivery (DSD) was agreed by 85.5% of the respondents as a key encouraging factor for SDM. Conclusion: HIV positive clients experience a high level of involvement in the various steps of SDM with their doctor and this is in line with the preference of the majority- SDM. However, duration on ART can play a key role in their preferences for SDM with the doctor.

Keywords: Evaluation, HIV-positive patients, patients’ involvement, healthcare decision making.