{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:57:10Z","timestamp":1788541030703,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence on frontline implementation of integrated HIV\/TB prevention in resource-limited, ethnic minority regions remains limited. Liangshan Yi Autonomous Prefecture in Southwest China carries a dual HIV\/TB burden. This study explored healthcare workers\u2019 experiences with China\u2019s Integrated Prevention and Control of Four Diseases (IPC4D) policy to identify barriers and enablers of service integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative phenomenological study was conducted from July to December 2024. 37 semi-structured interviews were held with purposively sampled healthcare workers across prefectural CDCs, infectious disease hospitals, county hospitals, and township health centers. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed following Braun and Clarke\u2019s six-phase framework. Reflexive memos and triangulation across facility levels, professional roles, and ethnic groups enhanced study rigor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four themes emerged. First, policy-driven progress: participants reported greater governmental support, increased resource inputs, and modest improvements in public awareness. Second, structural barriers: chronic underfunding of TB services, workforce shortages, and burnout weakened integration. Third, the multi-sectoral \u201c1\u202f+\u202fM\u202f+\u202fN\u202f+\u202fP\u201d model\u2014local government leadership (\u201c1\u201d), township centers (\u201cM\u201d), village doctors and maternal\u2013child health staff (\u201cN\u201d), and public security departments (\u201cP\u201d)\u2014expanded service reach but also generated task overload, cultural\u2013linguistic challenges, and inter-sectoral friction. Fourth, urban\u2013rural divergence: township providers faced more severe infrastructure gaps and patient non-adherence, often driven by stigma and financial constraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The IPC4D policy demonstrates potential to reduce HIV\/TB disparities in Liangshan, yet sustained progress requires dedicated TB financing, culturally competent workforce training, rational task redistribution, and stigma-reduction strategies that leverage Yi community networks. These findings provide practical insights for adapting integrated disease-control policies in other high-burden, resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1615781","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T05:29:11Z","timestamp":1760419751000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Healthcare workers\u2019 experiences with integrated HIV and TB prevention in Liangshan, China: a qualitative exploration of barriers and enablers"],"prefix":"10.3389","volume":"13","author":[{"given":"Ruili","family":"Bi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunnong","family":"Jike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ju","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"ref1","article-title":"Tuberculosis 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