Information, motivation, and behavioral skills for early pre-ART engagement in HIV care among patients entering clinical care in KwaZulu-Natal, South Africa.
Information, motivation, and behavioral skills for early pre-ART engagement in HIV care among patients entering clinical care in KwaZulu-Natal, South Africa.
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南非夸祖鲁-纳塔尔省进入临床护理的患者在 ART 前早期参与 HIV 护理的信息、动机和行为技能。
DOI：
10.1080/09540121.2013.775398
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发表时间：
2013
期刊：
影响因子：
1.7
通讯作者：
SAOptionsTeam
中科院分区：
文献类型：
--
作者：
Smith,LaramieR;Amico,KRivet;Shuper,PaulA;Christie,Sarah;Fisher,WilliamA;Cornman,DeborahH;Doshi,Monika;MacDonald,Susan;Pillay,Sandy;Fisher,JeffreyD;SAOptionsTeam
在撒哈拉以南非洲，尚不符合抗逆转录病毒治疗（前ART）条件的个人早期参与和保留艾滋病毒护理的因素知之甚少。识别这些因素对于支持保留在ART前临床护理，以确保及时启动ART和优化长期健康结果至关重要。我们评估了在南非夸祖鲁-纳塔尔新诊断的不符合ART条件的患者中，患者接受ART治疗前的HIV护理相关信息、动机和行为技能。该调查由采访者对符合条件的患者进行，这些患者年龄在18岁或以上，新进入护理（在过去六个月内诊断），并且没有资格在四个初级保健临床地点之一接受ART（CD 4计数> 200个细胞/mm 3）。自我报告的信息，动机和行为技能，具体保留在前ART艾滋病护理的特点是分类反应到那些反映潜在的优势和那些反映潜在的缺陷。信息、动机和行为技能缺陷在整个样本中足够普遍（即，患病率≥30%）被确定为需要通过适应临床水平的干预措施予以特别关注的领域。还评估了性别差异。共有288名患者（75%为女性）完成了结构化访谈。在整个样本中，八个信息，八个动机和八个行为技能缺陷领域被确定为足够普遍，以保证具体的有针对性的关注。性别差异没有出现。在ART前艾滋病毒护理相关的信息，动机和行为技能，已确定的赤字表明，需要努力提高免疫功能和艾滋病毒疾病的准确信息，是准确的信息艾滋病毒治疗和传播风险开始ART之前。进一步努力促进社会支持的发展，包括与诊所工作人员的积极互动，减少社区一级的耻辱，并减少艾滋病毒护理的结构性和资源消耗的需求，可能是特别有价值的，以促进保留在ART前艾滋病毒护理。
Little is known regarding factors implicated in early engagement and retention in HIV care among individuals not yet eligible for antiretroviral therapy (pre-ART) in sub-Saharan Africa. Identifying such factors is critical for supporting retention in pre-ART clinical care to ensure timely ART initiation and optimize long-term health outcomes. We assessed patients' pre-ART HIV care-related information, motivation, and behavioral skills among newly diagnosed ART-ineligible patients, initiating care in KwaZulu-Natal, South Africa. The survey was interviewer-administered to eligible patients, who were aged 18 years or older, newly entering care (diagnosed within the last six-months), and ineligible for ART (CD4 count > 200 cells/mm3) in one of four primary care clinical sites. Self-reported information, motivation, and behavioral skills specific to retention in pre-ART HIV-care were characterized by categorizing responses into those reflecting potential strengths and those reflective of potential deficits. Information, motivation, and behavioral skills deficits sufficiently prevalent in the overall sample (i.e.,≥30% prevalent) were identified as areas in need of specific attention through intervention efforts adapted to the clinic level. Gender-based differences were also evaluated. A total of 288 patients (75% female) completed structured interviews. Across the sample, eight information, eight motivation, and eight behavioral skills deficit areas were identified as sufficiently prevalent to warrant specific targeted attention. Gender differences did not emerge. The deficits in pre-ART HIV care-related information, motivation, and behavioral skills that were identified suggest that efforts to improve accurate information on immune function and HIV disease are needed, as is accurate information regarding HIV treatment and transmission risk prior to ART initiation. Additional efforts to facilitate the development of social support, including positive interactions with clinic staff and decreasing community-level stigma and to decrease structural and resource-depleting demands of HIV care may be particularly valuable to facilitate retention in pre-ART HIV care.