Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia.
Why Counseling Intervention Fails to Improve Compliance towards Antiretroviral Therapy: Findings from a Mixed-Methods Study among People Living with HIV in Bali Province, Indonesia.
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DOI：
10.3390/idr13010015
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发表时间：
2021-02-05
影响因子：
3.2
通讯作者：
Wirawan DN
中科院分区：
文献类型：
--
作者：
Sawitri AAS;Sutarsa IN;Merati KTP;Bakta IM;Wirawan DN
本研究探讨了咨询对提高艾滋病毒感染者 (PLHIV) 接受和坚持抗逆转录病毒治疗 (ART) 的贡献，并确定了与其实施相关的关键问题。我们于 2015 年至 2017 年间在巴厘岛省进行了一项纵向混合方法研究。研究参与者为 170 名新诊断的艾滋病毒感染者和 17 名外展咨询人员 (OW)。我们采访了艾滋病病毒感染者，了解他们接受咨询、接受和坚持抗逆转录病毒疗法的经历。我们调查了四个咨询领域（隐私、内容、频率和持续时间），并通过深入访谈探讨了主要发现。此外，还进行了 24 次离职面谈和记录审查。定量数据进行描述性分析，定性数据进行主题分析。在接受咨询计划的 170 名艾滋病毒感染者中，139 名（81.76%）接受了 ART，52 名（37.4%）在六个月的随访中停止了 ART。尽管咨询师涵盖了大部分内容（16/17 部分），但咨询的中位时间和频率不足。尽管在我们的研究地点为艾滋病病毒感染者提供了高分的艾滋病毒咨询，但对抗逆转录病毒疗法的总体接受和坚持仍然中等或中等。我们的研究表明，开始 ART 前的咨询不足以提高巴厘岛省对 ART 的接受度和依从性。这种有效性的降低受到内部问题（人际交往能力、有限的技术能力）和来自艾滋病毒携带者和社会的外部因素（耻辱、披露、歧视）的影响。
This study explores the contribution of counseling to improving acceptance of and adherence to anti-retroviral therapy (ART) among people living with HIV (PLHIV) and identifies key issues associated with its implementation. We conducted a longitudinal mixed-methods study in Bali Province between 2015 and 2017. The study participants were 170 newly diagnosed PLHIV and 17 outreach-counselor workers (OWs). We interviewed PLHIV for their experiences in receiving counseling, and acceptance of and adherence to ART. We surveyed four counseling domains (privacy, contents, frequency, and duration) and explored the key findings through in-depth interviews. In addition, 24 exit interviews and record reviews were performed. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Out of 170 PLHIV who received the counseling program, 139 (81.76%) accepted ART, and 52 (37.4%) discontinued ART in six months of follow up. Although counselors covered most of the content (16/17 components), the median time and frequency of counseling were insufficient. Despite a high score of HIV counseling provided to PLHIV in our study location, the overall acceptance of and adherence to ART remains fair or moderate. Our study suggests that counseling before ART initiation is inadequate for improving acceptance and adherence to ART in Bali Province. This reduced effectiveness is influenced by internal issues (interpersonal skills, limited technical capacity) and external factors both from PLHIV and society (stigma, disclosure, discrimination).
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影响因子：
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作者：
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DOI：
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DOI：
10.1080/09540121.2020.1742869
发表时间：
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影响因子：
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作者：
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