A qualitative study of Thai HIV-positive young men who have sex with men and transgender women demonstrates the need for eHealth interventions to optimize the HIV care continuum
A qualitative study of Thai HIV-positive young men who have sex with men and transgender women demonstrates the need for eHealth interventions to optimize the HIV care continuum
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DOI：
10.1080/09540121.2017.1286288
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发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Phanuphak, Nittaya
中科院分区：
文献类型：
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作者：
Anand, Tarandeep;Nitpolprasert, Chattiya;Phanuphak, Nittaya
在泰国，男男性行为者 (YMSM) 和跨性别女性 (TG) 受艾滋病毒影响尤为严重，并且连续护理结果不佳。尽管泰国 YMSM 和年轻的 TG 是新兴技术的早期采用者，并且具有较高的互联网和技术获取和利用率，但尚未利用技术潜力来优化艾滋病毒治疗级联。我们就护理挑战采访了 18 名行为感染 HIV 的 YMSM 和年轻 TG，确定了电子医疗如何满足护理需求，并得出对电子医疗干预措施的偏好。参与者报告说，他们在个人和社会层面的耻辱感中挣扎，这对护理的联系和保留以及抗逆转录病毒治疗的依从性产生了负面影响。 YMSM 和年轻的 TG 描述了面对面支持服务的不足，并严重依赖随机在线资源来填补信息和支持空白，但有时认为它们不值得信任或不一致。与会者普遍认可电子卫生资源的开发，并提出如何减轻个人对耻辱的恐惧并改善公众对艾滋病毒的看法。个性化和综合的电子卫生干预措施具有交互式、用户驱动的结构、可信的内容、参与奖励、实时咨询和提醒支持，可以帮助克服 YMSM 和年轻 TG 在传统艾滋病毒医疗系统中面临的障碍，并有可能改善护理结果。
In Thailand, young men who have sex with men (YMSM) and transgender women (TG) are disproportionately affected by HIV and have suboptimal care continuum outcomes. Although Thai YMSM and young TG are early adopters of emerging technologies and have high Internet and technology access and utilization, the potential of technology has not been harnessed to optimize the HIV treatment cascade. We interviewed 18 behaviorally HIV-infected YMSM and young TG regarding care challenges, identified how eHealth could address care needs, and elicited preferences for eHealth interventions. Participants reported struggling with individual and societal-level stigma which negatively impacted linkage to and retention in care, and antiretroviral therapy adherence. YMSM and young TG described inadequate in-person support services and heavily relied on random online resources to fill information and support gaps, but sometimes viewed them as untrustworthy or inconsistent. Participants universally endorsed the development of eHealth resources and proposed how they could ameliorate individual-level fears over stigma and improve public perceptions about HIV. Personalized and integrated eHealth interventions with interactive, user-driven structures, credible content, rewards for engagement, real-time counseling and reminder support could help overcome barriers YMSM and young TG face in traditional HIV healthcare systems and have the potential to improve care outcomes.