Determinants of Healthcare-Seeking Behaviour of People Living With HIV and AIDS (PLWHA) in South-East, Nigeria

Background: HIV/AIDS remains one of the major public health challenges in sub-Sahara Africa, where over 70% of global burden of the disease occurs. Nigeria – particularly the South-East with prevalence rate of 5.48%, which is above the WHO's 4% red line has an alarming burden of the disease and is said to be at an explosive stage of the disease. Factors that moderate PLWHA healthcare-seeking which in turn fuel and sustain such a high and ugly burden of HIV/AIDS in South-East, Nigeria, has not been investigated by previous studies. Objective: This study was conducted to assess the determinants of Healthcare-Seeking Behaviour (HCSB) among PLWHA in South-East, Nigeria. Five specific research questions and two hypotheses guided the study. Methodology: Using a descriptive survey design, the study accessed a sample of 400 PLWHA who registered in HIV clinics from 5 government-owned, three missionary and two privately owned hospitals across the South-East zone between the month of June and August 2015. Multiple cluster sampling technique was used to draw this sample from an estimated 931600 People Living with HIV/AIDS (PLWHA) in South-East, Nigeria. A self-structured, validated and pretested questionnaire titled PLWHA Healthcare-Seeking Behaviour Questionnaire (PHCSBQ) was the instrument used for data collection. The instrument was subjected to a reliability test using Pearson product moment correlation (r=0.94). Descriptive statistics of frequency counts, percentages, mean and standard deviation were used to analyze data. Inferential statistics of chi-square was used to test hypotheses at 0.05 level of significance. Results: Results showed that HCSB of PLWHA in South-East, Nigeria, reflected in their preference for treatment facilities and varied based on location and educational levels. Results also showed that place of residence (location) (1.83 + 0.17), educational level (1.86 + 0.23) and religio-cultural belief (1.76 + 0.084) were minor determinants whereas regularity of income (2.57 + 0.059) and stigmatization (2.63 + 0.046) were major determinants of PLWHA healthcare-seeking in South-East, Nigeria. The study also revealed that HCSB significantly differed between PLWHA in urban and rural areas. Furthermore, the study revealed that HCSB differed among PLWHA of different educational levels. Conclusion: Stigma and irregular income were major determinants of PLWHA's HCSB in South-East, Nigeria. There is need for vigorous health education campaign to enlighten the people more on the disease and tackle the devastating effect of stigma. It is imperative that Governments at different levels, donor agencies, and spirited affluent individuals collaborate in synergic fashion to institute financial social welfare packages that would be accessible on regular basis to PLWHA at various treatment facilities to mitigate the adverse effect of lack of regular income on healthcare-seeking behaviour of PLWHA.