The utilization of government social protection schemes by people living with HIV: A cross-sectional study in Chittoor district, Andhra Pradesh, India.

Abstract

Government Social protection schemes (GSPS) are critical to reduce the various socio-economic challenges faced by people living with HIV (PLWH). It is unclear whether the PLWH utilize the provision of these schemes to their benefit. This study was conducted to estimate the utilization of the social protection schemes by PLWH and to identify the facilitating and constraining factors in accessing the schemes. In this cross-sectional study, we recruited 94 participants from three anti-retroviral therapy (ART) zones in the district by purposive sampling. The participants were interviewed for the utilization of the pre-identified schemes, including the health scheme, financial aid, nutritional aid, housing, aid for their children, and life insurance/employment. The barriers and facilitating factors were simultaneously explored by thematic analysis. Utilization of the GSPS is high for health benefits (<i>n</i> = 84, 89.4%) and free ration (<i>n</i> = 85, 90%), but considerably lower for ART pension (<i>n</i> = 17, 18%), housing (<i>n</i> = 34, 36.2%), aid for children (<i>n</i> = 31, 38%), life insurance (<i>n</i> = 23, 24.5%) and legal assistance (<i>n</i> = 0, 0%). The enrolment in the schemes and availing thereof is often self-directed and infrequently supported by the health workers and the local leaders. Lack of awareness, administrative challenges, and perceived stigma are major barriers to availing the schemes. The participants expressed their concern about the behavior of their family members towards them, the perceived stigma, and the dire need for support to sustain their lives. Utilization of the social schemes by PLWH is quite complex. An integrated and inclusive approach to provide the GSPS is needed.