Healthcare providers' perspectives on factors influencing treatment choices for HIV-associated cryptococcal meningitis in Tanzania: a qualitative exploratory study in two regional referral hospitals.

OBJECTIVES: To explore healthcare providers' perspectives on factors influencing treatment selection for HIV-associated cryptococcal meningitis (CM) in Tanzania. DESIGN: A hospital-based qualitative exploratory study. SETTING: Dodoma and Singida Regions, Tanzania. PARTICIPANTS: 17 medical doctors, nurses and pharmacists working in the medical wards were purposely selected based on their clinical experience in managing adult patients with HIV-associated CM. RESULTS: Treatment choices were influenced by four major themes: (1) guideline awareness and transition from outdated practices; (2) provider experience, confidence and perceived competency; (3) recurrent stock-outs of amphotericin B, flucytosine and essential electrolyte supplements; and (4) patient-level financial barriers affecting access to monitoring and supportive care. CONCLUSION: HIV-associated CM treatment is shaped by healthcare providers, drug availability and patient-related factors. Targeted efforts to strengthen guideline dissemination, ensure uninterrupted antifungal supply and build provider capacity for safe amphotericin B use are crucial for improving CM outcomes.