Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa.
Informing comprehensive HIV prevention: a situational analysis of the HIV prevention and care context, North West Province South Africa.
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DOI：
10.1371/journal.pone.0102904
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Barnhart S
中科院分区：
文献类型：
--
作者：
Lippman SA;Treves-Kagan S;Gilvydis JM;Naidoo E;Khumalo-Sakutukwa G;Darbes L;Raphela E;Ntswane L;Barnhart S
建立一个成功的联合预防计划需要了解社区的当地流行病学概况、形成艾滋病毒易感性和获得护理的社会社区规范，以及可用的社区资源。我们进行了一项情况分析，以形成一个全面的艾滋病毒预防计划，在南非西北部省的多个背景水平上解决当地的护理障碍。2012年在两个分区进行了情况分析，并遵循了世卫组织的战略方针，这是一种主要是定性的方法，包括观察服务提供点，并与当地领导人、提供者和社区成员进行深入访谈和重点小组，以便建议针对具体情况的艾滋病毒预防战略。分析开始于田野调查期间，每晚讨论调查结果，并继续对田野调查笔记本中的原始文本数据进行编码，以及选定数量的录音访谈。我们进行了200多次个人和团体访谈，收集了艾滋病毒预防和护理的四个主要社会障碍，包括：艾滋病毒宿命论、传统性别规范、与艾滋病毒有关的耻辱以及围绕艾滋病毒的沟通挑战，所有这些都助长了艾滋病毒的流行。在遏制疫情所需的不同级别的应对措施中，我们发现了国家政策和计划正在缓解社会风险因素的证据，但几乎没有基于社区的应对措施来解决艾滋病毒的社会风险因素。了解护理的社会和结构性障碍有助于形成我们的全面艾滋病毒预防计划，该计划解决了该计划每个组成部分中确定的四个“主题”。目前正在开展活动，以吸引社区参与，在高传播地区提供基于社区的检测，减少社区污名，并制定积极的健康、尊严和预防方案，以减少污名并提高沟通技能。形势分析过程成功地形成了关键的方案决策，并培养了与当地利益攸关方的更深层次的合作，以支持方案的实施。
Building a successful combination prevention program requires understanding the community’s local epidemiological profile, the social community norms that shape vulnerability to HIV and access to care, and the available community resources. We carried out a situational analysis in order to shape a comprehensive HIV prevention program that address local barriers to care at multiple contextual levels in the North West Province of South Africa. The situational analysis was conducted in two sub-districts in 2012 and guided by an adaptation of WHO’s Strategic Approach, a predominantly qualitative method, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. Analysis began during fieldwork with nightly discussions of findings and continued with coding original textual data from the fieldwork notebooks and a select number of recorded interviews. We conducted over 200 individual and group interviews and gleaned four principal social barriers to HIV prevention and care, including: HIV fatalism, traditional gender norms, HIV-related stigma, and challenges with communication around HIV, all of which fuel the HIV epidemic. At the different levels of response needed to stem the epidemic, we found evidence of national policies and programs that are mitigating the social risk factors but little community-based responses that address social risk factors to HIV. Understanding social and structural barriers to care helped shape our comprehensive HIV prevention program, which address the four ‘themes’ identified into each component of the program. Activities are underway to engage communities, offer community-based testing in high transmission areas, community stigma reduction, and a positive health, dignity and prevention program for stigma reduction and improve communication skills. The situational analysis process successfully shaped key programmatic decisions and cultivated a deeper collaboration with local stakeholders to support program implementation.
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影响因子：
3.1
作者：
Campbell, Catherine;Nair, Yugi;Maimane, Sbongile
通讯作者：
Maimane, Sbongile
影响因子：
5.4
作者：
Campbell, C;MacPhail, C
通讯作者：
MacPhail, C
影响因子：
5.4
作者：
Dunkle, KL;Jewkes, RK;Harlow, SD
通讯作者：
Harlow, SD
DOI：
10.1016/s0955-3959(99)00056-0
发表时间：
2000-03-01
期刊：
The International journal on drug policy
影响因子：
--
作者：
Fitch;Rhodes;Stimson
通讯作者：
Stimson
DOI：
10.1097/01.aids.0000327435.28538.18
发表时间：
2008-08
期刊：
AIDS (London, England)
影响因子：
--
作者：
Greig A;Peacock D;Jewkes R;Msimang S
通讯作者：
Msimang S