Intricacies and inter-relationships between HIV disclosure and HAART: a qualitative study
Intricacies and inter-relationships between HIV disclosure and HAART: a qualitative study
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DOI：
10.1080/09540120410001716423
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发表时间：
2004-07-01
影响因子：
1.7
通讯作者：
Rotheram-Borus, MJ
中科院分区：
文献类型：
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作者：
Klitzman, RL;Kirshenbaum, SB;Rotheram-Borus, MJ
本研究旨在了解是否以及如何高活性抗逆转录病毒治疗（HAART）影响的意见和模式的披露，以及如何披露与治疗决策相互作用。152 HIV阳性的成年人（52男男性接触者，56名妇女和44 ID U男子）从美国四个城市参加了两到三个小时，半结构化的采访在1998-99年。结果表明，HAART互动和形状艾滋病毒披露问题在几个方面。因此，在不同的环境中（如工作场所、监狱、戒毒所和公共场合），有些人试图隐藏药物或修改给药时间表，这可能导致不遵守规定，并影响性行为。HIV和/或HAART的披露也可能导致对HAART持有负面态度和信念的其他人的对抗，可能会阻碍依从性。可观察到的药物副作用也可以“淘汰”个人。相反，药物可能会改善外观，延迟或阻碍披露。有些人等到他们接受HAART治疗，看起来“很好”才透露;有些人因为药物治疗而看起来很健康，但否认自己是艾滋病毒阳性。或者，艾滋病毒的披露可以导致支持，促进启动和坚持治疗。艾滋病毒的披露和遵守可以以关键的方式相互塑造。然而，这些相互作用尚未得到充分研究，需要进一步审查。关于这两个领域的干预措施和研究一般都是分开的，但需要加以整合，需要认识到这两个领域之间关系的重要性。
This study aimed to understand whether and how highly active antiretroviral treatment (HAART) affects views and patterns of disclosure and how disclosure interacts with treatment decisions. One hundred and fifty-two HIV-positive adults (52 MSM, 56 women and 44 ID U men) from four US cities participated in two to three-hour, semi-structured interviews in 1998-99. Results indicate that HAART interacts with and shapes HIV disclosure issues in several ways. Medications may 'out' people living with HIV Thus, in different settings (e.g. work, prisons, drug rehabs and public situations), some try to hide medications or modify dosing schedules, which can contribute to non-adherence, and affect sexual behaviours. Disclosure of HIV and/or HAART may also result in antagonism from others who hold negative attitudes and beliefs about HAART, potentially impeding adherence. Observable side effects of medications can also 'out' individuals. Conversely, medications may improve appearance, delaying or impeding disclosure. Some wait until they are on HAART and look 'well' before disclosing; some who look healthy as a result of medication deny being HIV-positive. Alternatively, HIV disclosure can lead to support that facilitates initiation of, and adherence to, treatment. HIV disclosure and adherence can shape one another in critical ways. Yet these interactions have been under-studied and need to be further examined. Interventions and studies concerning each of these domains have generally been separate, but need to be integrated, and the importance of relationships between these two areas needs to be recognized.