A RECENT PILOT STUDY on persons living with both HIV and Type 2 diabetes has found that the physical demands of diabetes were greater, while living with HIV bore a larger psychological toll.
Dr Madhuvanti Murphy, lecturer in Public Health, and Deputy Dean of Research & Graduate Studies in the Faculty of Medical Sciences, discussed the findings of the qualitative research during a recent interview.
The study was part of a larger research project titled, Strengthening Health Systems for Chronic Care: Intersection of Communicable and Non-Communicable Diseases Services in the Caribbean and South Africa. It was a collaborative effort with the University of Cape Town (UCT); the University of Limpopo (UL); Penn State University (PSU); and The UWI.
Other team members from the University included Professor T. Alafia Samuels, who is also the director of the George Alleyne Chronic Disease Research Centre; Dr Natalie Greaves, and Dr Shalini Pooransingh from the St Augustine campus. The pilot was funded by the Pan-University Network for Global Health, of which The UWI is a member.
Under the research, which was conducted in 2017, ten participants from Barbados and ten from Trinidad and Tobago were interviewed, ranging in age from 35 to 65 years old.
“We looked at workload capacity such as going to doctor’s appointments, [impacts on their] daily living, as well as their personal capacity, such as social support and networks. . .,” Dr Murphy said.
“We found that people living with both conditions . . . viewed how they managed them in different ways. When they spoke about HIV, [the participants] found that it was actually easy to manage in terms of taking the medication. The issue with HIV was more . . . psychological, in terms of the stigma and discrimination associated with it.
“With diabetes, they found that much more difficult to manage. There was much less psychological stress associated with it, but more of everything else – whether physical or otherwise – in terms of diet, medication and the constant testing . . . .”
Dr Murphy added that these findings could have significant impact on how health care providers dispense advice along with medications.
“Clearly there is a psychological effect that needs to be focused on for both diabetes and HIV, but particularly for the HIV, because you figure, ‘well I’ve prescribed the medication,’ but [there is] this big psychological burden that patients are experiencing that may not always come out, or [health care] providers may not always talk about with their patients.
“We need to be making sure that we have the psychological element of issues covered when providers are talking to people with co-morbidities. We also need to understand that with chronic non-communicable diseases, there is a lot of physical burden and there is a need to counsel patients through that.
“From a health systems standpoint, we also need to look at what we need to be providing for patients at a larger level and what will help them the most.”
Dr Murphy also noted that in the case of stigma and discrimination against persons living with HIV and AIDS, sensitisation on language use and confidentiality was also key.
“All of those things play into whether people are feeling discrimination, and there are some simple fixes, [particularly] once people think about what they say, and how they say it.”