Towards Creating an Enabling Environment for the Treatment and Care of HIV Patients Who Inject/ Use Drugs

This paper presents the findings of an exploratory analysis of the health system and an integrated medical and psycho-social support primarily for HIV infected persons who inject drugs and persons who use drugs (PWID/PWUD HIV-patients). It purports to provide a framework for an enabling environment to the stakeholders of HIV services: Health Care Workers (HCW), Drug Rehabilitation Administrators (DRA), and the PWID/PWUD HIV-patients. The study intends to inform policyholders of the problems and issues related to access of healthcare of a hidden, stigmatized, and discriminated key population of HIV patients who inject/use drugs. The findings of the study will provide evidence for policy consideration of the Philippine National AIDS Council (PNAC) in formulating health mechanisms and guidelines for PWID/PWUD with HIV. This is qualitative research that used the interview method. The instrument used was based on the 7th AIDS Medium Term Plan Enabling Environment Ecosystem. All 21 study participants consented to the interviews60% were PWID/PWUD-HIV patients while 40% were HCW (health care workers) and DRA (drug rehabilitation administrators). All interviews were conducted online by psychologists in the research team. The Consolidated Framework for Implementation Research (CFIR) was used as analytical framework. A thematic analysis of the interview results revealed nine factors of enabling environment for HIV prevention and treatment and drug rehabilitation. These factors are safe relationship and safe space, clear protocol and roles, community building, leadership, awareness, coordination and referral, legal procedures, external aid, and PWID/PWUD HIV patients’ identities, issues, and inner resources. The qualitative domains that appeared from the interviews will help find the breadth of content of each domain to develop a potential assessment instrument measuring an enabling environment. This study defines the concept of an enabling environment in the context of HIV and substance use which can inform national policies and guide future research in this area.