Barriers and Facilitators of Same-Day Antiretroviral Therapy Initiation Among People Newly Diagnosed with HIV in Ethiopia: Qualitative Study Using the Transtheoretical Model of Behavioral Change.
Barriers and Facilitators of Same-Day Antiretroviral Therapy Initiation Among People Newly Diagnosed with HIV in Ethiopia: Qualitative Study Using the Transtheoretical Model of Behavioral Change.
复制标题
DOI：
10.2147/jmdh.s282116
复制
发表时间：
2020
影响因子：
3.3
通讯作者：
Berhane Y
中科院分区：
文献类型：
--
作者：
Moges NA;Adesina OA;Okunlola MA;Berhane Y
艾滋病毒检测和治疗方法目前是埃塞俄比亚预防和控制计划的一部分。该战略采取在艾滋病毒诊断当天或下一次就诊时开始抗逆转录病毒治疗。然而，几乎没有证据表明，在埃塞俄比亚的同一天（ART）启动的障碍和促进因素。因此，本研究的目的是调查障碍和促进者的同一天（ART）开始在埃塞俄比亚西北部。在埃塞俄比亚西北部的东Gojjam区进行了定性研究。有目的地选择的HIV患者，医护人员和治疗助理参加了定性研究。通过深入访谈和焦点小组讨论（FGD）收集数据。通过ATLAS.ti软件按主题进行编码。访谈和家庭指导文件以阿姆哈拉语（当地语言）进行，然后逐字转录并翻译成英文。通过ATLAS.ti软件进行编码。采用主题分析方法，使用跨理论行为模型（TTM）的结构来显示新诊断的艾滋病毒在准备开始治疗的过程中所经历的变化阶段。共有19名患者，12名治疗支持者和9名医护人员参加了定性研究。对检查结果感到震惊、没有任何症状、不信任检查结果以及寻求圣水的灵性治疗是在诊断当天或下一次就诊时开始ART的主要障碍。在HIV诊断过程中，在早期阶段观察到更多的障碍，而在TTM的后期阶段出现了治疗促进者。TTM模型可用于描述参与者在变革阶段的特征。
HIV test and treat approach is currently a strategy used as a part of the prevention and control program in Ethiopia. The strategy adopts initiating antiretroviral therapy (ART) on the same-day as HIV diagnosis or in the next visit. However, there is little evidence on barriers and facilitators of same-day (ART) initiation in Ethiopia. Therefore, this study aimed to investigate barriers and facilitators of same-day (ART) initiation in the northwest Ethiopia. A qualitative study was conducted in East Gojjam Zone in northwest Ethiopia. Purposively selected HIV patients, healthcare workers, and treatment assistants participated in the qualitative study. Data were collected through in-depth interviews and focus group discussions (FGDs). Coding was done via ATLAS.ti software thematically. The interviews and FGDs were conducted in Amharic (local language) and then transcribed verbatim and translated into English. Coding was done via ATLAS.ti software. The thematic analysis approach was employed using the constructs of the transtheoretical behavioral model (TTM) to show stages of change that newly HIV diagnosed experienced in the course of preparation for treatment initiation. A total of 19 patients, 12 treatment supporters, and 9 healthcare workers participated in the qualitative study. Shocking due to the test result, having no symptoms, mistrust of the test result, and seeking spiritual healing from holy water were the major barriers to start ART in the same-day of diagnosis or within the next visit. During HIV diagnosis, more barriers were observed in the early stages, while treatment facilitators emerged in the later stages of TTM. The TTM model can be applied to characterize where participants were in the stages of change.