Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth
Qualitative Comparison of Barriers to Antiretroviral Medication Adherence Among Perinatally and Behaviorally HIV-Infected Youth
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DOI：
10.1177/1049732317697674
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发表时间：
2017-07-01
影响因子：
3.2
通讯作者：
Mimiaga, Matthew J.
中科院分区：
文献类型：
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作者：
Fields, Errol L.;Bogart, Laura M.;Mimiaga, Matthew J.
青年艾滋病毒感染者（28%-69%）的药物依从性往往不足以抑制病毒。依从障碍的社会心理背景是复杂的。我们试图定性地了解行为感染和围产期感染青年的依从性障碍，并针对他们的需求制定一项干预措施。我们对30名感染艾滋病毒的青年（14-24岁）进行了深入访谈，并使用恒定比比法分析了转录本。障碍受到临床和社会心理因素的影响。围产期感染青少年的障碍包括抗拒、复杂的治疗方案、艾滋病毒疲劳和难以过渡到自主护理。行为感染青年的障碍包括与艾滋病毒有关的羞耻和难以开始用药。两组都报告了低风险认知、提醒HIV的药物治疗和保密，但描述了这些常见障碍的不同背景。对于行为感染和围产期感染的青年，出现了共同和独特的障碍，反映了不同的艾滋病毒经历和社会心理环境。我们开发了一种可定制的干预措施，针对已确定的障碍及其心理社会因素。
Medication adherence among youth living with HIV (28%-69%) is often insufficient for viral suppression. The psychosocial context of adherence barriers is complex. We sought to qualitatively understand adherence barriers among behaviorally infected and perinatally infected youth and develop an intervention specific to their needs. We conducted in-depth interviews with 30 youth living with HIV (aged 14-24 years) and analyzed transcripts using the constant comparative method. Barriers were influenced by clinical and psychosocial factors. Perinatally infected youth barriers included reactance, complicated regimens, HIV fatigue, and difficulty transitioning to autonomous care. Behaviorally infected youth barriers included HIV-related shame and difficulty initiating medication. Both groups reported low risk perception, medication as a reminder of HIV, and nondisclosure, but described different contexts to these common barriers. Common and unique barriers emerged for behaviorally infected and perinatally infected youth reflecting varying HIV experiences and psychosocial contexts. We developed a customizable intervention addressing identified barriers and their psychosocial antecedents.