Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services-A Qualitative Study in 19 Ugandan Districts
Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services-A Qualitative Study in 19 Ugandan Districts
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DOI：
10.1155/2018/9619684
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Abongomera, George
中科院分区：
文献类型：
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作者：
Bajunirwe, Francis;Tumwebaze, Flora;Abongomera, George
背景联合国艾滋病规划署制定了到2020年实现90-90-90的新目标。为了实现这一目标，目前的方案需要解决限制艾滋病毒检测和治疗服务的获取、可用性和利用的挑战。因此，本研究的目的是确定的障碍，影响访问，可用性和利用艾滋病毒服务在乌干达农村地区的一个大型捐助者资助的计划。方法.我们与地区一级的利益攸关方、现有艾滋病毒/艾滋病项目的工作人员以及19个地区的卫生设施进行了关键的知情人访谈。数据也收集了从焦点小组讨论组成的客户介绍艾滋病毒的护理和治疗。使用内容分析法对数据进行转录和分析。结果查明的障碍如下：（1）保健设施缺乏包括抗逆转录病毒药物在内的药物。一些患者害怕开始抗逆转录病毒治疗，因为担心短缺;（2）距离和（3）人员短缺;（4）耻辱持续存在;（5）缺乏社会和经济支持举措，以提高治疗的保留率。结论.总之，我们的研究确定了影响艾滋病毒服务的获得，可用性和利用的几个因素。方案需要解决药物和工作人员短缺、艾滋病毒污名化和远离卫生设施等问题，以扩大获得和利用机会，从而实现艾滋病规划署的目标。
Background. UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods. We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions. In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target.