Many people with HIV/AIDS in Serbia and Montenegro experience stigma, loneliness and ostracism, and can find it difficult to secure work and support themselves, according to new research findings.
They also struggle to secure regular, continuous access to HIV/AIDS drug treatments even though, in theory, there is 100% access to state-funded delivery, and are suffering stress and anxiety as a result.
Sarah Bernays, of the London School of Hygiene & Tropical Medicine (LSHTM)'s Centre for Drugs and Health Behaviour, will be presenting initial findings from the three-year study at an international health briefing on HIV/AIDS 2008, which is being held at Tanaka Business School, Imperial College today.
The study has relevance regionally and globally because, as the world aims to scale up to universal access, it is likely that already overstretched health care systems will run into difficulties with supply security, leaving patients temporarily without appropriate treatment. There are reports that people living with HIV (PLHIV) have experienced interrupted treatment due to supply problems within the region, for example Russia and Turkey, and also in countries where the prevalence rates are much higher, for example Uganda and Burundi.
The LSHTM team carried out qualitative research between 2005 and 2007. A baseline study, conducted between 2005-6, and funded by the UK Department for International Development, involved in-depth interviews with 40 PLHIV in Serbia and Montenegro, and 18 service providers. A prospective study, which took place between 2006 and 2007 and which was funded by the European Social Research Council, followed up 20 PLHIV. East participant was interviewed a further three times, and written and/or audio diaries were collected.
The respondents reported high levels of stigma attached to HIV/AIDS, and perceived access to HIV treatment to be insecure. They felt that there were problems with the delivery of drugs, and that both drugs and monitoring tests were in short supply. They reported feeling anxious at these perceived failings. Serbia and Montenegro is a transitional state, and the underlying context of uncertainty - politically, economically and due to possible future conflict - is seen as a threat to accessing HIV treatment.
One respondent commented: 'It's very depressing you know to go there and to wait so many hours and every time is the same fear, will there be some medicines or not. I'm living with this fear'. Another spoke of being ostracised and abused by neighbours. One interviewee reported how his family had also suffered since his diagnosis; his father's house, which had previously always been full of visitors, was now always empty, as people were afraid to visit.