A qualitative study of barriers to enrollment into free HIV care: perspectives of never-in-care HIV-positive patients and providers in Rakai, Uganda.
A qualitative study of barriers to enrollment into free HIV care: perspectives of never-in-care HIV-positive patients and providers in Rakai, Uganda.
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DOI：
10.1155/2013/470245
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发表时间：
2013
影响因子：
--
通讯作者：
Gray R
中科院分区：
文献类型：
--
作者：
Nakigozi G;Atuyambe L;Kamya M;Makumbi FE;Chang LW;Nakyanjo N;Kigozi G;Nalugoda F;Kiggundu V;Serwadda D;Wawer M;Gray R
背景。在撒哈拉以南非洲，早期接受艾滋病毒治疗的情况很低。在Rakai，大约三分之一（31.5%）的艾滋病毒阳性客户在知道自己的血清状态后没有参加免费护理服务。本定性研究探讨了艾滋病毒阳性客户进入护理的障碍，这些客户从未登记过护理和艾滋病毒护理提供者。方法。我们对15-49岁的艾滋病毒感染者进行了48次深入访谈，这些人在收到结果并转诊接受免费治疗后6个月内没有接受治疗。与12个提供者进行了关键信息提供者访谈。对访谈进行录音和文字记录，并根据健康信念模型进行专题内容分析。结果。使用艾滋病毒护理的障碍包括害怕耻辱和艾滋病毒暴露，妇女缺乏男性伴侣的支持，繁重的工作时间表和高昂的运输费用。规划障碍包括对抗逆转录病毒药物副作用的恐惧，漫长的等待和旅行时间，以及工作人员对患者的不尊重。否认感染艾滋病毒、相信精神治疗和没有艾滋病症状也是障碍。结论。需要采取有针对性的干预措施，消除耻辱感，加强夫妻咨询和健康教育方案，解决性别不平等问题，并实施对患者友好和灵活的诊所服务时间，以消除艾滋病毒护理的障碍。
Background. Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5%) of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. Methods. We conducted 48 in-depth interviews among HIV-infected individuals aged 15–49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Results. Barriers to using HIV care included fear of stigma and HIV disclosure, women's lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Conclusion. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.
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DOI：
10.1097/qai.0b013e3181a44ef2
发表时间：
2009-06-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
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通讯作者：
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