Abstract
BACKGROUND: In sub-Saharan Africa, the rising burden of noncommunicable diseases (NCDs), such as diabetes mellitus (DM) and hypertension (HT), coexists with the ongoing challenge of HIV, a leading cause of death. People living with HIV (PLHIV) also have NCDs, which may affect their healthcare experiences. This study explored patient perceptions of the quality of care received by PLHIV, with and without NCDs, at an antiretroviral treatment (ART) clinic in an urban district hospital in KwaZulu-Natal, South Africa. METHODS: A sequential mixed-methods design was employed, comprising quantitative and qualitative phases. A structured questionnaire was systematically administered to 301 patients, followed by semi-structured interviews with ten purposively selected persons living with HIV (PLHIV), either without comorbidities or diagnosed with HT, DM, or both. Quantitative data were analysed using factor analysis and Principal Component Analysis (PCA) to identify key themes, while qualitative data were analysed using thematic content analysis based on the Donabedian Framework. RESULTS: Quantitative findings indicated that 86% of patients expressed overall satisfaction with their care. However, qualitative insights highlighted structural, procedural, and outcome-related challenges, including long waiting times, staff shortages, and varying perceptions of healthcare provider competence. Patients prioritised HIV treatment. While some instances of integrated care were reported, fragmented service delivery remained prevalent. CONCLUSION: Although most patients reported positive care experiences, long waiting times and inadequate staffing negatively impacted service delivery. Strengthening health education is essential to improve patient adherence. Expanding integrated care and addressing staffing shortages could enhance the overall quality of care for PLHIV, particularly those with comorbid NCDs.