Muskan Rastogi¹ Prof Dr Sanjeev Dave 2, Dr Rashmi Pandey 3, Prof Dr Anuradha V Dave4, Dr Ridima Kamal 5
Affiliation(s):
¹First Author, Master of Public Health Candidate, Indian Institute of Public Health, Odisha, India; 2 HOD Community Medicine, Autonomous State Medical College, Auraiy, Uttar Pradesh; 3 Asstt Prof Biochemistry, Govt Medical College Haridwar (Uttarakhand);4 Professor Community Medicine, Subharti Medical College, Meerut, Uttar Pradesh;5 Consultant Public Health, AIIMS New Delhi
Abstract
Background: Acquired Immunodeficiency Syndrome (AIDS) continues to be a major global health challenge, with India having one of the highest burdens of people living with HIV (PLHIV). Despite advances in treatment, many individuals face significant barriers to timely testing, care, and treatment adherence due to poor health-seeking behavior.
Objective: This scoping review aims to synthesize existing research on the health-seeking behaviors of PLHIV in India and to identify the key factors influencing their decisions, to inform improved service delivery.
Methods: We conducted a systematic search across PubMed, Scopus, and Google Scholar, following the PRISMA-ScR framework. The review included 17 peer-reviewed primary studies published in English, spanning from 2004 to May 2024. Data were synthesized using both descriptive quantitative and qualitative thematic analysis.
Results: The review identified three primary barriers to health-seeking behavior: pervasive stigma, which delayed testing and treatment; social inequities, including gender and income disparities, that restricted access to care; and health system limitations, such as long travel distances and fragmented services, which contributed to poor retention. Conversely, the review found that peer and family support, as well as innovative digital health approaches, were key facilitators. The evidence base was concentrated in southern and western India, with critical gaps in central, eastern, and northeastern regions and among marginalized populations.
Conclusion: Health-seeking behaviour among PLHIV in India is shaped by a complex interplay of social and systemic barriers. Based on these findings, we recommend targeted interventions to address these barriers, including stigma reduction efforts and the development of community-based, patient-centred care. Addressing evidence gaps in underrepresented populations and regions is crucial for informing scalable, equitable interventions in India.
Keywords: Health-seeking behaviour, HIV, AIDS, India, Stigma, Barriers
