Barriers to Tuberculosis Care for Drug Users in Two Provinces of China: a Qualitative Study

Setting: Two compulsory drug rehabilitation centres in Yunnan and Sichuan Provinces, Southwest China.

Objective: To understand barriers to tuberculosis (TB) care among drug users in China, and to provide policy recommendations to improve TB control in the drug-using population.

Design: A qualitative study was designed using in-depth interviews with 147 drug users with TB and 12 key informants. Drug users were purposively selected from two compulsory drug rehabilitation centres and key informants from national and provincial justice administration, local TB control dispensaries and compulsory drug rehabilitation centres.

Results: Lack of health awareness and knowledge was reported as one barrier to TB care among drug users. The majority of the respondents lacked social support and perceived fear and stigma when seeking TB care. More than half of the respondents who had discontinued their anti-tuberculosis treatment reported that this was due to drug use. Limited provision of TB care in the compulsory drug rehabilitation centres and local TB control dispensaries was also reported as one of the barriers to TB care among drug users.

Conclusions: These findings suggest that barriers to TB care for drug users are associated not only with the drug users themselves, but also with the providers and societal factors. Health professionals and policy makers should be aware of these barriers in China.