Home and health among people living with HIV who use drugs: A qualitative study.
Home and health among people living with HIV who use drugs: A qualitative study.
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DOI：
10.1016/j.drugpo.2020.102729
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
McNeil R
中科院分区：
文献类型：
--
作者：
Fleming T;Collins AB;Bardwell G;Fowler A;Boyd J;Small W;McNeil R
住房是艾滋病毒感染者（PLHIV）中使用药物的艾滋病毒相关结果的关键决定因素，包括艾滋病毒治疗依从性。研究表明，家的感觉可能对减轻使用药物的艾滋病毒感染者与低收入住房环境相关的危害具有重要意义，但这如何影响治疗却知之甚少。从加拿大温哥华的一个正在进行的前瞻性队列中招募了31名使用药物的PLHIV患者进行了半结构化访谈。招募对象是以前报告治疗依从性较低的住单间住房的个人。访谈由同行研究助理共同主持，重点是住房条件、药物使用模式和艾滋病毒管理。采访记录下来，按主题分析，并通过借鉴家庭和场所制作的概念进行解释。通过培养安全感和创造个性化空间，对住房环境进行控制的能力有助于参与者对家的感知。与会者很快就确定了住房稳定性和质量对保持健康（例如食品储存、无虫害），包括艾滋病毒护理的重要性。然而，根据破坏代理的社会结构机制，家庭的负面经历对治疗依从性产生了不利影响。研究结果表明，家的感觉可以提高管理艾滋病毒护理的能力，并通过在住房环境中的安全感和对住房环境的控制来促进。需要在竞争激烈的住房市场中提供支持，以解决家庭在艾滋病毒治疗依从性方面发挥的作用。
Housing is a critical determinant of HIV-related outcomes among people living with HIV (PLHIV) who use drugs, including on HIV treatment adherence. Research shows that sense of home may have important implications for mitigating harms associated with low-income housing environments among PLHIV who use drugs, but how this shapes treatment is poorly understood. Semi-structured interviews were conducted with 31 PLHIV who use drugs recruited from an ongoing prospective cohort in Vancouver, Canada. Recruitment was targeted towards individuals living in single room occupancy housing who had previously reported low treatment adherence. Interviews were co-led with a peer research assistant, and focused on housing conditions, drug use patterns, and HIV management. Interviews were transcribed, analyzed thematically, and interpreted by drawing on concepts of home and place-making. The ability to exert control over housing environments contributed to participants’ perceptions of home by fostering feelings of safety and allowing for creation of personalized space. Participants readily identified the importance of housing stability and quality in maintaining health (e.g. food storage, pest-free), including HIV care. However, informed by social-structural mechanisms that undermined agency, negative experiences of home adversely impacted treatment adherence. Findings indicate that sense of home may enable ability to manage HIV care, and is promoted through feelings of security within, and control over, housing environments. Supports in navigating competitive housing markets are needed to address the role that home plays in HIV treatment adherence.
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