Improving ART initiation among men who use HIV self-testing in Malawi: a qualitative study.
Improving ART initiation among men who use HIV self-testing in Malawi: a qualitative study.
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DOI：
10.1002/jia2.25950
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发表时间：
2022-06
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
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艾滋病毒自我检测（HIV - st）增加了男性接受艾滋病毒检测的人数；然而，艾滋病毒感染者与抗逆转录病毒治疗（ART）的联系很低。我们需要创新的抗逆转录病毒治疗策略，但人们对男性艾滋病毒感染者在接受治疗时遇到的独特障碍以及男性希望获得何种与抗逆转录病毒治疗相关的干预措施知之甚少。我们对马拉维在2018年至2020年期间使用HIV检测呈阳性的顺性男性（≥15岁）进行了半结构化的深度访谈，并对其分发HIV检测试剂盒的女性伴侣（≥15岁）进行了访谈。来自七家机构的医疗记录被用来确定应答者。我们纳入了从卫生机构接受艾滋病毒传播的男性（初次分布）和从性伴侣处接受艾滋病毒传播的男性（二次分布）。访谈指南侧重于艾滋病毒感染后开始抗逆转录病毒治疗的独特障碍以及改善联系和开始治疗的所需干预措施。访谈录音，翻译和转录成英文，并在Atlas中使用持续比较方法进行分析。ti v.8.4。通过hiv传播策略对主题进行比较。数据收集于2019年至2020年之间。27名受访者接受了采访：8名男性/女性二人组（16名受访者），8名没有女性伴侣的男性和3名代表未参与研究的男性的女性。在所代表的19名男子中（16名男子亲自访问，3名男子由女性伴侣的二次报告代表），7人通过初次分发获得艾滋病毒感染，12人通过二次分发获得艾滋病毒感染。6名男性从未接受过抗逆转录病毒治疗（均为继发性hiv传播）。开始抗逆转录病毒治疗的障碍集中在诊断时缺乏卫生保健工作者，包括缺乏与护理联系的外部动机（男性必须自我激励），以及在检测前后缺乏咨询（留下与抗逆转录病毒治疗相关的恐惧和误解未得到解决）——后者在继发艾滋病毒感染中尤其如此。期望的干预措施在分布策略中是相似的，包括持续的同伴指导，使治疗依从性正常化，为男性量身定制的咨询信息，便利和隐私的设施外服务，以及帮助男性了解如何前往ART诊所的设施导航。男性艾滋病毒感染者在接受抗逆转录病毒治疗方面面临着独特的挑战，特别是那些通过二次传播接受艾滋病毒感染者。男性需要量身定制的干预措施，这可能有助于克服护理障碍。
HIV self‐testing (HIVST) increases HIV testing uptake among men; however, the linkage to antiretroviral therapy (ART) among HIVST users is low. Innovative strategies for ART initiation are needed, yet little is known about the unique barriers to care experienced by male HIVST users, and what ART‐related interventions men desire. We conducted semi‐structured in‐depth interviews with cisgender men (≥15 years) in Malawi who tested HIV positive using HIVST between 2018 and 2020, as well as interviews with their female partners (≥15 years) who distributed the HIVST kits. Medical records from seven facilities were used to identify respondents. We included men who received HIVST from a health facility (primary distribution) and from sexual partners (secondary distribution). Interview guides focused on unique barriers to ART initiation following HIVST and desired interventions to improve linkage and initiation. Interviews were audio recorded, translated and transcribed to English, and analysed using constant comparison methods in Atlas.ti v.8.4. Themes were compared by HIVST distribution strategy. Data were collected between 2019 and 2020. Twenty‐seven respondents were interviewed: eight male/female dyads (16 respondents), eight men without a female partner and three women who represented men who did not participate in the study. Among the 19 men represented (16 men interviewed in person, three represented by secondary report from female partners), seven received HIVST through primary distribution, 12 through secondary distribution. Six men never initiated ART (all secondary HIVST distribution). Barriers to ART initiation centred on the absence of healthcare workers at the time of diagnosis and included lack of external motivation for linkage to care (men had to motivate themselves) and lack of counselling before and after testing (leaving ART‐related fears and misconceptions unaddressed)––the latter was especially true for secondary HIVST distribution. Desired interventions were similar across distribution strategies and included ongoing peer mentorship for normalizing treatment adherence, counselling messages tailored to men, outside‐facility services for convenience and privacy, and facility navigation to help men understand how to navigate ART clinics. Male HIVST users face unique challenges to ART initiation, especially those receiving HIVST through secondary distribution. Male‐tailored interventions are desired by men and may help overcome barriers to care.
影响因子：
8.1
作者：
Neuman M;Fielding KL;Ayles H;Cowan FM;Hensen B;Indravudh PP;Johnson C;Sibanda EL;Hatzold K;Corbett EL
通讯作者：
Corbett EL