The experience of "medicine companions" to support adherence to antiretroviral therapy: quantitative and qualitative data from a trial population in Uganda
The experience of "medicine companions" to support adherence to antiretroviral therapy: quantitative and qualitative data from a trial population in Uganda
复制标题
DOI：
10.1080/09540120903500027
复制
发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Grosskurth, H.
中科院分区：
文献类型：
--
作者：
Foster, S. D.;Nakamanya, S.;Grosskurth, H.
良好的依从性对于撒哈拉以南非洲地区的抗逆转录病毒治疗 (ART) 至关重要。我们报告了乌干达参加 ART 的患者选择的医学伴侣 (MC) 的特征，以及 MC 的选择方式以及他们所扮演的角色。对乌干达金贾的一项随机对照试验中的 1453 名参与者的 MC 基线数据进行了比较，该试验比较了 ART 的设施和家庭交付。关于 MC 经验的文本数据是通过对 40 名试验参与者的子样本进行深入访谈而收集的，这些参与者按性别和试验组平均分配。招募的女性 (71%) 明显多于男性 (29%)。大多数（75%）女性参与者要么丧偶（51%），要么分居或离婚（24%），而大多数男性（66%）已婚。女性最有可能选择孩子作为MC，而男性最有可能选择配偶； 41% 的女性选择 21 岁以下的 MC，而男性的这一比例仅为 14%。只有 31% 的已婚女性选择了自己的丈夫，而 66% 的已婚男性选择了自己的妻子。定性访谈表明，事实证明，在前三个月中，MC 对于提醒和其他支持性任务很有用，但到了六个月及以后，其重要性通常会降低。便利性、可靠性和信任是选择 MC 的关键考虑因素。孩子是许多未婚女性唯一的选择，但即使是一些已婚女性也认为孩子比丈夫更可靠。披露血清状况的参与者通常会收到多个家庭成员的吸毒提醒。定性样本中的一名家庭关系较差的参与者由于不愿意识别 MC 而推迟了开始治疗。 MC 普遍受到欢迎，并且在支持早期遵守方面很有用。然而，向 MC 披露不应成为获得治疗的条件。
Good adherence is critical for antiretroviral therapy (ART) in sub-Saharan Africa. We report on the characteristics of medicine companions (MCs) chosen by Ugandan patients enrolling on ART, and on how MCs were chosen, and what roles they played. Baseline data on MCs of 1453 participants in a randomized controlled trial comparing facility and home-based delivery of ART in Jinja, Uganda were analyzed. Textual data on experience with MCs were collected through in-depth interviews among a subsample of 40 trial participants equally divided by sex and trial arm. Significantly more women (71%) than men (29%) were recruited. The majority (75%) of women participants were either widowed (51%) or separated or divorced (24%), whereas most of the men (66%) were married. Women were most likely to choose a child as their MC while men were most likely to choose their spouse; 41% of women chose an MC under 21 compared with only 14% of men. Only 31% of married women chose their husband, compared with 66% of married men who chose their wife. Qualitative interviews suggested MCs proved useful for reminding and other supportive tasks in the first three months but were generally less essential by six months and beyond. Convenience, reliability, and trust were key considerations in choosing an MC. Children provided the only alternative for many unmarried women, but even some married women felt children made more reliable MCs than husbands. Participants who had disclosed their serostatus usually received drug-taking reminders from multiple household members. One participant in the qualitative sample with poor family relations delayed starting treatment due to unwillingness to identify an MC. MCs were generally welcome and useful in supporting early adherence. However, disclosure to an MC should not be a condition of obtaining treatment.