Table 4 ConQual summary of the findings
Synthesized Findings | Type of Research | Dependability | Credibility | ConQual Score |
|---|---|---|---|---|
1. Although the current healthcare systems have many barriers preventing PLWH with NCDs from accessing both HIV and NCD care, they can receive resources and knowledge through healthcare providers. | Qualitative | Downgrade 1 level | – | Medium |
2. The factors that can affect care continuity and treatment adherence for both HIV and NCDs among PLWH include the individual physical, mental, and financial statuses of PLWH; their relationships with clinicians; and fragmented healthcare systems. | Qualitative | Downgrade 1 level | Downgrade 1 level | Low |
3. PLWH with NCDs have long-term physical and psychological manifestations of disease. Psychological manifestations are severe and prevalent when PLWH are informed that they have NCDs. Some changes, including changes in appearance and sexual function, can affect individuals’ daily lives, especially among women living with HIV and NCDs. | Qualitative | Downgrade 1 level | Downgrade 1 level | Low |
4. Having more chronic conditions implies more medical costs for PLWH. The more severe the financial hardship of PLWH, the more negatively it affects their employment and family relationships. | Qualitative | Downgrade 1 level | – | Medium |
5. PLWH with NCDs experience double stigma toward their HIV and chronic conditions, which may exacerbate their perceived discrimination and lead to social and physical isolation. | Qualitative | Downgrade 1 level | – | Medium |
6. PLWH with NCDs have high levels of polypharmacy burden for both ART and other medications. This population has difficulty maintaining high medication adherence due to medication fatigue, side effects, and the large numbers of pills to be taken. PLWH with NCDs may spontaneously use some strategies individually or collectively to achieve high levels of medication adherence. | Qualitative | Downgrade 1 level | Downgrade 1 level | Low |
7. Some PLWH with NCDs consider hypertension and cancer more concerning conditions than HIV. However, they still describe the ability of HIV to hibernate. Having NCDs may mask concerns regarding HIV and HIV-positive experiences, which can reinforce the self-management of NCDs. | Qualitative | Downgrade 1 level | – | Medium |
8. While facing HIV with NCDs, PLWH can develop positive coping strategies to accept the realities of living with multiple chronic conditions. | Qualitative | Downgrade 1 level | Downgrade 1 level | Low |
9. Some PLWH living with chronic diseases struggle with new daily routines, emotional difficulties, and family issues. In extreme cases, PLWH may have suicidal ideation when experiencing high pressure. | Qualitative | Downgrade 1 level | – | Medium |