Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country

Socioeconomic Inequalities as a Cause of Health Inequities in Spain: A Scoping Review

The objectives of this review were to identify the population groups most frequently studied, to determine the methods and techniques most commonly used to show health inequities, and to identify the most frequent socioeconomic and health indicators used in the studies on health inequities due to socioeconomic inequalities that have been carried out on the Spanish healthcare system. A scoping review was carried out of the studies conducted in the Spanish State and published in literature since 2004, after the publication of the Law of Cohesion and Quality of the National Health System. The PRISMA extension for scoping reviews was followed. The methodological quality of the studies was assessed using the critical reading guides of the Joanna Briggs Institute and an adaptation of the STROBE guide for ecological studies. A total of 58 articles out of 811 articles were included. Most of the articles were (77.59%, n = 45) cross-sectional studies, followed by ecological studies (13.8%, n = 8). The population group used was uneven, while the main geographical area under investigation was the whole state (51.7%, n = 30) compared to other territorial distributions (48.3%, n = 28). The studies used a multitude of health and socioeconomic indicators, highlighting self-perception of health (31.03%, n = 19) and social class (50%, n = 29). The relationship between better health and better socioeconomic status is evident. However, there is variability in the populations, methods, and indicators used to study health equity in Spain. Future health research and policies require greater systematization by public institutions and greater cooperation among researchers from disciplines such as sociology, economics, and health.

Socioeconomic inequality in knowledge about HIV/AIDS over time in Ethiopia: A population-based study

Socioeconomic inequality in comprehensive knowledge about HIV/AIDS can hinder progress towards ending the epidemic threat of this disease. To address the knowledge gap, it is essential to investigate inequality in HIV/AIDS services. This study aimed to investigate socioeconomic inequality, identify contributors, and analyze the trends in inequality in comprehensive knowledge about HIV/AIDS among adults in Ethiopia. A cross-sectional study was conducted using 2005, 2011, and 2016 population-based health survey data. The sample size was 18,818 in 2005, 29,264 in 2011, and 27,261 in 2016. Socioeconomic inequality in comprehensive knowledge about HIV/AIDS was quantified by using a concentration curve and index. Subsequently, the decomposition of the concentration index was conducted using generalised linear regression with a logit link function to quantify covariates' contribution to wealth-based inequality. The Erreygers' concentration index was 0.251, 0.239, and 0.201 in 2005, 2011, and 2016, respectively. Watching television (24.2%), household wealth rank (21.4%), ever having been tested for HIV (15.3%), and education status (14.3%) took the significant share of socioeconomic inequality. The percentage contribution of watching television increased from 4.3% in 2005 to 24.2% in 2016. The household wealth rank contribution increased from 14.6% in 2005 to 21.38% in 2016. Education status contribution decreased from 16.2% to 14.3%. The percentage contribution of listening to the radio decreased from 16.9% in 2005 to -2.4% in 2016. The percentage contribution of residence decreased from 7.8% in 2005 to -0.5% in 2016. This study shows comprehensive knowledge about HIV/AIDS was concentrated among individuals with a higher socioeconomic status. Socioeconomic-related inequality in comprehensive knowledge about HIV/AIDS is woven deeply in Ethiopia, though this disparity has been decreased minimally. A combination of individual and public health approaches entangled in a societal system are crucial remedies for the general population and disadvantaged groups. This requires comprehensive interventions according to the primary health care approach.

Risk factors of dropout from institutional delivery among HIV positive antenatal care booked mothers within one year postpartum in Ethiopia: a case-control study

Background

The uptake of maternal healthcare services remains suboptimal in Ethiopia. Significant proportions of antenatal care attendees give birth at home in the context of HIV. However, in Ethiopia, evidence is scarce on the predictors of dropout from maternity continuum of care among HIV-positive mothers. Therefore, this study aimed to supply valuable information on risk factors regarding dropout of HIV-positive mothers for institutional delivery services in northwest Ethiopia.

Methods

A multicenter case–control study was conducted at governmental health facilities in Gondar City from May one to June 30/2018. A total of 222 HIV-positive women were included in the study. Data were collected using structured questionnaires and checklists through face-to-face interview and chart review; entered into EPI INFO version seven, and then exported to SPSS version 25. Both descriptive and analytical procedures were performed. Binary logistic regression analysis was undertaken. A significant association was declared based on the adjusted odds ratio (AOR) with its 95% CI and p-value of ≤ 0.05.

Results

This study illustrates that maternal age of ≥ 35 years (AOR = 2.37; 95%CI: 1.13,5.13), unmarried marital relation (AOR = 3.28; 95%CI: 1.51, 7.13), unemployed spousal occupation (AOR = 3.91; 95%CI: 1.54, 9.91), family monthly income of ≤ 36 US dollar (AOR = 4.87; 95%CI: 2.08, 11.42) and no obstetric complication in the index pregnancy (AOR = 13.89; 95%CI: 2.73, 27.71) were positively associated with dropout from institutional delivery among HIV positive antenatal care booked mothers.

Conclusion

In this study, the risk factors of dropout from institutional delivery in the context of HIV-positive women were connected to social determinants of health such as advanced maternal age, unmarried marital status, unemployed husband occupation, and low family income. Therefore, interacting with the health system by focusing on these women in lower socio-economic strata and unmarried HIV-positive ANC attendees, and increasing access to information on obstetric complications during the antenatal care visit would retain clients in the continuum of maternity services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-022-00819-0.

Determinants of the quality of life amongst HIV clinic attendees in Malang, Indonesia

BACKGROUND

As the number of people living with human immunodeficiency virus (HIV; PLHIV) in Indonesia has increased in recent years, more efforts have been expended to improve their health status. However, in a country where PLHIV are very much stigmatized, there has been little research concerning their quality of life (QoL). Hence, this study aimed to assess the QoL among PLHIV and its associated factors. Findings of this research can contribute to improving the health and wellbeing of PLHIV in Indonesia.

METHODS

A cross-sectional survey with convenience sampling was conducted from June to September 2018, at four healthcare centers in Malang, Indonesia. PLHIV, aged 18 years or over, were asked if they would like to participate in this study when they came to a health center to receive services. To protect confidentiality, the healthcare staff at the clinics assisted with recruitment and face-to-face interviews with structured questionnaires. Measurements included sociodemographic, medication-related, social support, HIV-stigma, and QoL variables.

RESULTS

In total, 634 PLHIV agreed to participate in this study. A multivariate linear regression analysis showed that being older, having a job, living in an urban area, having better access to healthcare services, adhering to medication, being in an antiretroviral therapy (ART) program for more than 1 year, experiencing a lower level of stigma, and receiving more social support were associated with a better QoL. The regression model had an adjusted R2 of 0.21.

CONCLUSIONS

Findings from this research have significant policy implications. Policies focused on reducing social stigma and promoting medication adherence will likely have a positive impact on the QoL of PLHIV. Increasing public awareness and acceptance of PLHIV in Indonesia remains challenging, but would likely have significant impacts. Furthermore, interventions should also focus on reducing disparities in QoL between PLHIV living in rural areas and those in urban areas.