Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe

Abstract Background People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients’ liv...

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Main Authors: Rumbidzai Chireshe, Tawanda Manyangadze, Keshena Naidoo
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-025-12949-6
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author Rumbidzai Chireshe
Tawanda Manyangadze
Keshena Naidoo
author_facet Rumbidzai Chireshe
Tawanda Manyangadze
Keshena Naidoo
author_sort Rumbidzai Chireshe
collection DOAJ
description Abstract Background People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients’ lived experiences and expectations is vital for designing responsive service-delivery models. Methods A cross-sectional, descriptive, qualitative study was conducted at primary healthcare facilities in Harare, Zimbabwe. Semi-structured interviews were conducted with 20 adults diagnosed with both HIV infection and T2DM. The data were transcribed, translated (where necessary), and analyzed using thematic analysis. Results Four overarching themes emerged: (1) fragmented versus integrated care (2), time and out-of-pocket expenses (3), healthcare provider attitudes and behaviours, and (4) unmet needs and expectations. Participants reported challenges, such as multiple appointments, financial burdens, lack of confidentiality, and limited counselling. Positive experiences included culturally competent care and integrated service delivery, where available. Conclusion Primary care services should be restructured to provide integrated, holistic, and patient-centered care for individuals with HIV and T2DM comorbidities. Health provider training, infrastructure development, and access to medication are key to improving the outcomes.
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spelling doaj-art-e61bbdfdad144ff29a4bb1410fc434142025-08-20T03:20:06ZengBMCBMC Health Services Research1472-69632025-06-012511810.1186/s12913-025-12949-6Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, ZimbabweRumbidzai Chireshe0Tawanda Manyangadze1Keshena Naidoo2Discipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-NatalDiscipline of Public Health Medicine, College of Health Sciences, University of KwaZulu-NatalDepartment of Family Medicine, School of Nursing and Public Health, University of KwaZulu-NatalAbstract Background People living with Human Immunodeficiency Virus (HIV) and comorbid type 2 diabetes mellitus (T2DM) require integrated and patient-centered care. However, primary healthcare systems have been slow to address the needs of patients with multi-morbidities. Understanding patients’ lived experiences and expectations is vital for designing responsive service-delivery models. Methods A cross-sectional, descriptive, qualitative study was conducted at primary healthcare facilities in Harare, Zimbabwe. Semi-structured interviews were conducted with 20 adults diagnosed with both HIV infection and T2DM. The data were transcribed, translated (where necessary), and analyzed using thematic analysis. Results Four overarching themes emerged: (1) fragmented versus integrated care (2), time and out-of-pocket expenses (3), healthcare provider attitudes and behaviours, and (4) unmet needs and expectations. Participants reported challenges, such as multiple appointments, financial burdens, lack of confidentiality, and limited counselling. Positive experiences included culturally competent care and integrated service delivery, where available. Conclusion Primary care services should be restructured to provide integrated, holistic, and patient-centered care for individuals with HIV and T2DM comorbidities. Health provider training, infrastructure development, and access to medication are key to improving the outcomes.https://doi.org/10.1186/s12913-025-12949-6Primary healthcareHIVType 2 diabetes mellitusPatient expectationsIntegrated careZimbabwe
spellingShingle Rumbidzai Chireshe
Tawanda Manyangadze
Keshena Naidoo
Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
BMC Health Services Research
Primary healthcare
HIV
Type 2 diabetes mellitus
Patient expectations
Integrated care
Zimbabwe
title Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
title_full Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
title_fullStr Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
title_full_unstemmed Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
title_short Lived experiences and expectations of people living with HIV and co-morbid diabetes regarding primary care services in Harare, Zimbabwe
title_sort lived experiences and expectations of people living with hiv and co morbid diabetes regarding primary care services in harare zimbabwe
topic Primary healthcare
HIV
Type 2 diabetes mellitus
Patient expectations
Integrated care
Zimbabwe
url https://doi.org/10.1186/s12913-025-12949-6
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AT keshenanaidoo livedexperiencesandexpectationsofpeoplelivingwithhivandcomorbiddiabetesregardingprimarycareservicesinhararezimbabwe