Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient's perspective in Johannesburg, South Africa.
Why do patients interrupt and return to antiretroviral therapy? Retention in HIV care from the patient's perspective in Johannesburg, South Africa.
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DOI：
10.1371/journal.pone.0256540
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Rees K
中科院分区：
文献类型：
--
作者：
Bisnauth MA;Davies N;Monareng S;Buthelezi F;Struthers H;McIntyre J;Rees K
HIV 感染者 (PLHIV) 需要保留护理才能获得最佳临床结果。尽管南非的大多数艾滋病毒感染者都知道自己的艾滋病毒感染状况，但只有 70% 的人接受了抗逆转录病毒治疗 (ART)。需要提高护理的保留率，才能更接近所有人的持续抗逆转录病毒疗法。 2019 年 1 月，Anova 健康研究所开展了一项活动，鼓励中断 ART 的患者重新接受治疗。数据收集是在约翰内斯堡的一个地区进行的。这项混合方法研究由两个部分组成：1) 医疗保健提供者将数据输入到结构化工具中，供九个月内在九个诊所重新开始 ART 的所有患者使用，2) 对一小部分患者进行半结构化访谈。对工具的反应进行了描述性分析，我们报告了频率和百分比。采用主题方法深入分析参与者的经历。 562 人重新开始 ART，其中 66% 是女性，75% 年龄在 25-49 岁之间。脱离护理的三个最常见原因是行动不便（30%）、ART 相关因素（15%）和工作时间限制（10%）。返回的原因包括去诊所变得更容易（34%）和担心无法接受抗逆转录病毒疗法（19%）。移动访谈参与者经常忘记他们的医疗档案，并表示管理他们的 ART 很困难，因为他们经常需要转学信才能在另一家机构获得 ART。另一方面，具有灵活和延长工作时间的诊所有利于保留护理。在定量数据和定性分析中，生活环境的变化是脱离护理的最主要原因。人们认为卫生服务无法对生活变化或流动性做出反应，从而导致脱离。更多以客户为中心、反应迅速的医疗服务应能提高 ART 的保留率。
Retention in care is required for optimal clinical outcomes in people living with HIV (PLHIV). Although most PLHIV in South Africa know their HIV status, only 70% are on antiretroviral therapy (ART). Improved retention in care is needed to get closer to sustained ART for all. In January 2019, Anova Health Institute conducted a campaign to encourage patients who had interrupted ART to return to care. Data collection was conducted in one region of Johannesburg. This mixed methods study consisted of two components: 1) healthcare providers entered data into a structured tool for all patients re-initiating ART at nine clinics over a nine-month period, 2) Semi-structured interviews were conducted with a sub-set of patients. Responses to the tool were analysed descriptively, we report frequencies, and percentages. A thematic approach was used to analyse participant experiences in-depth. 562 people re-initiated ART, 66% were women, 75% were 25–49 years old. The three most common reasons for disengagement from care were mobility (30%), ART related factors (15%), and time limitations due to work (10%). Reasons for returning included it becoming easier to attend the clinic (34%) and worry about not being on ART (19%). Mobile interview participants often forgot their medical files and expressed that managing their ART was difficult because they often needed a transfer letter to gain access to ART at another facility. On the other hand, clinics that had flexible and extended hours facilitated retention in care. In both the quantitative data, and the qualitative analysis, changing life circumstances was the most prominent reason for disengagement from care. Health services were not perceived to be responsive to life changes or mobility, leading to disengagement. More client-centred and responsive health services should improve retention on ART.
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DOI：
10.1097/qai.0000000000001284
发表时间：
2017-04-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Clouse K;Vermund SH;Maskew M;Lurie MN;MacLeod W;Malete G;Carmona S;Sherman G;Fox MP
通讯作者：
Fox MP
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影响因子：
15.8
作者：
Fox MP;Bor J;Brennan AT;MacLeod WB;Maskew M;Stevens WS;Carmona S
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Carmona S
影响因子：
2.9
作者：
Sanga ES;Lerebo W;Mushi AK;Clowes P;Olomi W;Maboko L;Zarowsky C
通讯作者：
Zarowsky C
影响因子：
6
作者：
Shabalala FS;Vernooij E;Pell C;Simelane N;Masilela N;Spiegelman D;Chai B;Khan S;Reis R
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Reis R
影响因子：
11.8
作者：
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通讯作者：
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