Table 3 Classification of the deterrents and facilitators affecting health care utilization by HIV/AIDS people and women with risky sexual behaviors in Behavioral Diseases Counseling (BDCCs) and Vulnerable Women’s Counseling Centers (VWCCs) in Iran
Category | Subcategory | Sub-subcategory |
|---|---|---|
Medical and operational processes | Counseling services considerations | Counseling the clients even before admission and administrative operations on their first visit to BDCCs and VWCCs |
Counseling in a room with the doors closed to keep the client calm | ||
Identity information considerations | Not insisting on receiving identity information of HIV/AIDS patients and sex workers | |
Considering the fear of patient regarding disclosure of their disease and the importance of following confidentiality principles by the personnel | ||
Requirements of storing identity information of HIV/AIDS and sex workers and how to keep them safe | ||
Providing remote services for patients | Reaching health services to HIV/AIDS patients without coming to BDCCs and VWCCs in person as much as possible | |
Considerations and requirements of using phone for follow-ups | ||
Enhancement and diversification of services and reducing social stigma | Providing services, regardless of the cause of the HIV/AIDS, and not focusing on the real cause | |
Diversifying the range of diseases covered by the BDCCs, not only HIV/AIDS patients | ||
Providing complementary specialized diagnostic tests and supportive non-medical services | ||
Avoiding provision of specialized health services in specific weekdays and preventing gathering of patients in the BDCCs | ||
Giving patients hope of having a normal life and ensuring them of the effectiveness of the medication and treatment | ||
Mutual interactions between personnel and visitors (people living with and at the risk of getting HIV/AIDS) | Personnel behavior | Not judging and reproaching HIV/AIDS patients and sex workers |
Having normal and friendly behavior with HIV/AIDS patients | ||
Previous patients satisfied with and trusted in BDCCs and VWCCs as a key factor to assure new cases to visit these centers | ||
Training the personnel regarding the principles of interaction with HIV/AIDS patients | ||
Getting a better physical and mental feeling in each visit | ||
Wearing a formal uniform | ||
Concerns of visitors | Patients’ concerns about seeing familiar personnel | |
Concerning about legal problems | ||
Avoiding changing the personnel working in BDCCs and VWCCs | ||
Concerns about taking medications | ||
Precautions by visitors | Excuses and tricks of patients and vulnerable women in their first visit | |
Using disguise and protective equipment to remain anonymous | ||
Going to the BDCCs and VWCCs during the last working hours: Spending the minimum possible time in the center | ||
Physical characteristics of centers | Location of BDCCs and VWCCs | Area of operation: in a quiet or crowded place? |
Working as separate and independent BDCCs and VWCCs as or as a part of a larger building? | ||
Establishing fixed centers and not changing the location BDCCs and VWCCs | ||
Physical space (size) of BDCCs and VWCCs | ||
Geographical distribution of BDCCs and VWCCs | Physical distance between BDCCs and VWCCs and living place of people | |
Not having a catchment area and no geographical division for BDCCs and VWCCs | ||
Increasing the number of BDCCs and VWCCs | ||
Physical evidence | The sign board of the BDCCs and VWCCs | |
Not having surveillance cameras installed | ||
Not using signs of HIV/AIDS in the BDCCs |