Experiences and perceptions of health professionals towards the quality of care for people living with HIV in Tunisia: a qualitative study

Introduction: human immunodeficiency virus (HIV) infection continues to be a public health issue, especially in low-and middle-income countries, including Tunisia. In 2020, 32% of people living with HIV were on treatment. Management of HIV infection remains a real challenge for both patients and care providers. Our study aimed to describe the perceptions and attitudes of health professionals toward care for people living with HIV (PLHIV). Methods: a qualitative study was carried out between 2020 and 2021. Interviews with key informants were conducted in order to identify the strengths and weaknesses of the care for PLHIV, as well as their suggestions for improvement. Eight key informants in HIV care from different profiles were interviewed: healthcare providers from a specialized university hospital, the Ministry of Health, and civil society representatives working in the field of HIV. Interviews were transcribed and analyzed thematically using "QDA Miner" software. Results: the frequency of PLHIV who have interrupted medical follow-up was perceived as worrisome, and increasing. Along with individual factors, non-adherence to treatment was also attributed to systemic factors related to stock shortages, geographical inaccessibility, and shortfall in human resources. Stigmatization of PLHIV in healthcare facilities outside the specialized hospital was also highlighted. This has been linked to gaps in the training of care providers on the modes of the virus transmission. Conclusion: health professionals face many challenges in the care of PLHIV. There is an urgent need to improve treatment availability and accessibility, strengthen social assistance for PLHIV and fight against stigmatization, especially in healthcare settings.