Designing effective U = U communication strategies considering the needs of PLHIV, their partners, and healthcare worker constraints in South African clinics.
Designing effective U = U communication strategies considering the needs of PLHIV, their partners, and healthcare worker constraints in South African clinics.
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DOI：
10.1371/journal.pone.0295920
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
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作者：
我们试图了解艾滋病毒感染者（PLHIV）的不可检测=不可传播（U = U）沟通需求以及南非医疗保健提供者（HCPs）之间U = U沟通的障碍。我们与HCPs （N = 42）进行了5次焦点小组讨论（fgd），包括来自南非豪登省和自由邦省初级卫生保健诊所（PHCs）的护士和咨询师，3名fgd （N = 27）通过民间社会组织的滚雪球抽样招募的PLHIV患者，以及约翰内斯堡27名最近诊断出PLHIV的深度访谈（IDIs）。对IDIs和fgd进行录音、转录、翻译成英语，并进行主题分析。由于这一信息似乎与主流艾滋病毒预防临床指导相矛盾，PLHIV在很大程度上不知道并怀疑U = U。低病毒载量（VL）知识进一步降低了对U = U的信心，PLHIV需要在分享U = U信息和向伴侣披露其VL状态的最佳途径上得到支持和指导，强调社区对U = U和VL的理解在调解U = U对PLHIV的期望的污名减少、社会接受和情感利益方面的核心作用。由于担心风险补偿和抗逆转录病毒疗法的不依从性，以及担心可能导致任何随后的艾滋病毒传播，医护人员对分享U = U感到不安。卫生保健服务提供者还需要一个简单、明确和一致的U = U叙述，并与其他艾滋病毒预防信息相结合。hiv和HCPs都建议采用以患者为中心的方法来沟通U = U，主要侧重于实现病毒抑制，并强调只有在坚持抗逆转录病毒治疗期间，无安全套性行为才是安全的。这些数据强调了针对HCP和PLHIV的简单U = U通信支持的必要性。文化上合适的沟通材料，加上诊所工作人员的培训和持续指导，对于改善诊所以患者为中心的U = U沟通至关重要。
We sought to understand the Undetectable = Untransmittable (U = U) communication needs of persons living with HIV (PLHIV) and barriers to U = U communication among healthcare providers (HCPs) in South Africa. We conducted five focus group discussions (FGDs) with HCPs (N = 42) including nurses and counsellors from primary healthcare clinics (PHCs) in the Gauteng and Free State Provinces of South Africa, three FGDs (N = 27) with PLHIV recruited by snowball sampling from civil society organizations, and 27 in-depth interviews (IDIs) with recently diagnosed PLHIV in Johannesburg. IDIs and FGDs were audio recorded, transcribed, translated to English, and analysed thematically. PLHIV were largely unaware and sceptical of U = U as the message appeared to contradict the mainstream HIV prevention clinical guidance. The low viral load (VL) knowledge further reduced confidence in U = U. PLHIV need support and guidance on the best approaches for sharing U = U information and disclosing their VL status to their partners, highlighting the central role of community understanding of U = U and VL to mediate the desired stigma reduction, social acceptance and emotional benefits of U = U for PLHIV. HCPs were uneasy about sharing U = U due to concerns about risk compensation and ART non-adherence and worried about enabling any ensuing HIV transmission. HCPs also need a simple, unambiguous, and consistent narrative for U = U, integrated with other HIV prevention messages. PLHIV and HCPs alike recommended a patient-centred approach to communicating U = U, focusing primarily on attaining viral suppression and emphasizing that condomless sex is only safe during periods of ART adherence. These data highlight the need for simple U = U communication support targeting both HCP and PLHIV. Culturally appropriate communication materials, with training and ongoing mentorship of the clinic staff, are essential to improve patient-centred U = U communication in clinics.
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影响因子：
4.9
作者：
Rivera AV;Carrillo SA;Braunstein SL
通讯作者：
Braunstein SL
DOI：
10.1056/nejmoa1600693
发表时间：
2016-09-01
期刊：
The New England journal of medicine
影响因子：
--
作者：
Cohen MS;Chen YQ;McCauley M;Gamble T;Hosseinipour MC;Kumarasamy N;Hakim JG;Kumwenda J;Grinsztejn B;Pilotto JH;Godbole SV;Chariyalertsak S;Santos BR;Mayer KH;Hoffman IF;Eshleman SH;Piwowar-Manning E;Cottle L;Zhang XC;Makhema J;Mills LA;Panchia R;Faesen S;Eron J;Gallant J;Havlir D;Swindells S;Elharrar V;Burns D;Taha TE;Nielsen-Saines K;Celentano DD;Essex M;Hudelson SE;Redd AD;Fleming TR;HPTN 052 Study Team
通讯作者：
HPTN 052 Study Team
影响因子：
3.6
作者：
Bor J;Musakwa N;Onoya D;Evans D
通讯作者：
Evans D
影响因子：
6
作者：
Ngure, Kenneth;Ongolly, Fernandos;Baeten, Jared M.
通讯作者：
Baeten, Jared M.
影响因子：
3.7
作者：
通讯作者：
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