"We did not know what was wrong"-Barriers along the care cascade among hospitalized adolescents with HIV in Gaborone, Botswana.
"We did not know what was wrong"-Barriers along the care cascade among hospitalized adolescents with HIV in Gaborone, Botswana.
复制标题
DOI：
10.1371/journal.pone.0195372
复制
发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Lowenthal ED
中科院分区：
文献类型：
--
作者：
Enane LA;Mokete K;Joel D;Daimari R;Tshume O;Anabwani G;Mazhani L;Steenhoff AP;Lowenthal ED
感染艾滋病毒的青少年的高死亡率反映出护理连锁反应的延误和失败。我们试图阐明在博茨瓦纳三级转诊医院住院的艾滋病毒青少年中错过的严重护理机会和障碍。我们纳入了 2015 年 7 月至 2016 年 1 月期间因怀孕以外的任何诊断而住院的所有 HIV 感染青少年（年龄 10-19 岁）。对医疗记录进行了临床变量和过去护理参与情况的审查。对青少年（如果可行）及其照顾者进行半结构化访谈，探讨护理的延误和障碍。确定了 21 名符合条件的青少年，并招募了 15 名青少年。除一例外，所有病例均处于世界卫生组织临床第 3 或第 4 阶段。诊断障碍包括缺乏对围产期艾滋病毒感染、母亲患病或死亡的认识以及对歧视的恐惧。坚持抗逆转录病毒治疗的障碍包括保密、隔离和心理健康问题。住院的艾滋病毒感染青少年人数低于预期。然而，在住院患者中，缺乏及时诊断以及随后护理级联中的差距阐明了改善这一弱势群体的结果和生活质量的机会。
High mortality among adolescents with HIV reflects delays and failures in the care cascade. We sought to elucidate critical missed opportunities and barriers to care among adolescents hospitalized with HIV at Botswana’s tertiary referral hospital. We enrolled all HIV-infected adolescents (aged 10–19 years) hospitalized with any diagnosis other than pregnancy from July 2015 to January 2016. Medical records were reviewed for clinical variables and past engagement in care. Semi-structured interviews of the adolescents (when feasible) and their caregivers explored delays and barriers to care. Twenty-one eligible adolescents were identified and 15 were enrolled. All but one were WHO Clinical Stage 3 or 4. Barriers to diagnosis included lack of awareness about perinatal HIV infection, illness or death of the mother, and fear of discrimination. Barriers to adherence to antiretroviral therapy included nondisclosure, isolation, and mental health concerns. The number of hospitalized HIV-infected adolescents was lower than expected. However, among those hospitalized, the lack of timely diagnosis and subsequent gaps in the care cascade elucidated opportunities to improve outcomes and quality of life for this vulnerable group.
登录
查看更多内容
DOI：
10.1080/09540121.2015.1110234
发表时间：
2016-04-02
影响因子：
1.7
作者：
Ojwang', V. O.;Penner, J.;Cohen, C. R.
通讯作者：
Cohen, C. R.
影响因子：
11.8
作者：
Ferrand, Rashida A.;Luethy, Ruedi;Corbett, Elizabeth L.
通讯作者：
Corbett, Elizabeth L.
影响因子：
2.6
作者：
Kondracki, NL;Wellman, NS;Amundson, DR
通讯作者：
Amundson, DR
影响因子：
34.3
作者：
Farahani, Mansour;Vable, Anusha;Marlink, Richard
通讯作者：
Marlink, Richard
影响因子：
168.9
作者：
Newell, ML;Coovadia, H;Dabis, F
通讯作者：
Dabis, F