"They have already thrown away their chicken": barriers affecting participation by HIV-infected women in care and treatment programs for their infants in Blantyre, Malawi.
"They have already thrown away their chicken": barriers affecting participation by HIV-infected women in care and treatment programs for their infants in Blantyre, Malawi.
复制标题
DOI：
10.1080/09540121.2012.656570
复制
发表时间：
2012
期刊：
影响因子：
1.7
通讯作者：
Van Rie A
中科院分区：
文献类型：
--
作者：
Donahue MC;Dube Q;Dow A;Umar E;Van Rie A
感染艾滋病毒的婴儿和幼儿患重病和死亡的风险很高。通过婴儿早期诊断艾滋病毒和及时开始抗逆转录病毒治疗，可以大大降低发病率和死亡率。尽管全球努力扩大EID和婴儿抗逆转录病毒疗法的规模，但在资源贫乏、艾滋病毒负担高的国家，这些服务的接受率仍然很低。我们对59名感染艾滋病毒的妇女进行了定性研究，以确定和探索妇女在获得艾滋病毒检测和照顾婴儿方面面临的障碍。为了获得不同的观点，我们纳入了婴儿已知阳性（n=9）或已知阴性（n=14）的母亲，婴儿未知HIV状态的母亲（n=13）和HIV感染的孕妇（n=20）。出现了五个重要主题：缺乏关于EID和婴儿抗逆转录病毒疗法的知识，将卫生保健工作者视为权威人物，害怕披露自己和/或儿童的艾滋病毒状况，缺乏心理支持，以及意图缩短儿童的生命。一系列复杂的文化、经济和心理社会因素为感染艾滋病毒的妇女参加早期婴儿艾滋病毒检测和护理方案造成了障碍。为了使EID和婴儿抗逆转录病毒疗法产生最佳影响，应该更好地理解吸收不良的原因，并以文化敏感的方式加以解决。
HIV-infected infants and young children are at high risk of serious illness and death. Morbidity and mortality can be greatly reduced through early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy (ART). Despite global efforts to scale-up of EID and infant ART, uptake of these services in resource poor, high HIV burden countries remains low. We conducted a qualitative study of 59 HIV-infected women to identify and explore barriers women face in accessing HIV testing and care for their infants. To capture different perspectives, we included mothers whose infants were known positive (n=9) or known negative (n=14), mothers of infants with unknown HIV status (n=13), and pregnant HIV-infected women (n=20). Five important themes emerged: lack of knowledge regarding EID and infant ART, the perception of health care workers as authority figures, fear of disclosure of own and/or child’s HIV status, lack of psychosocial support, and intent to shorten the life of the child. A complex array of cultural, economic and psychosocial factors creates barriers for HIV-infected women to participate in early infant HIV testing and care programs. For optimal impact of EID and infant ART, reasons for poor uptake should be better understood and addressed in a culturally sensitive manner.