The impact of incarceration upon adherence to HIV treatment among HIV-positive injection drug users: a qualitative study
The impact of incarceration upon adherence to HIV treatment among HIV-positive injection drug users: a qualitative study
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DOI：
10.1080/09540120802511869
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发表时间：
2009-06-01
影响因子：
1.7
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Small, Will;Wood, Evan;Kerr, Thomas
导论.艾滋病毒呈阳性的注射吸毒者往往得不到高效抗逆转录病毒疗法的充分益处。在注射吸毒者中，最近的监禁与非临床原因停止HAART有关。我们试图定性评估经验与HAART艾滋病毒阳性IDU谁最近被关押在省级监狱在不列颠哥伦比亚省，以确定影响因素坚持治疗。12个深入的定性访谈进行了招募的男性队列研究（访问），涉及超过450艾滋病毒阳性注射吸毒者。所有参与者在开始HAART后都被监禁。录音采访进行了检查HAART在监狱中的经验，特别注意坚持和治疗中止的经验。参与者叙述了在拘留期间坚持艾滋病毒治疗受到影响的情况。少数参与者报告称，由于无法通过机构医疗保健获得艾滋病毒药物，治疗中断持续了一周多。据说，在进入教养系统期间和从拘留所释放时，短期中断治疗是很常见的。对艾滋病毒的高度歧视促使囚犯通过努力谨慎地服药来隐藏他们是艾滋病毒阳性的事实，这可能导致漏服药物。目前的研究确定了矫正环境中的背景因素，阻碍个人坚持HAART的能力。这些调查结果还表明，需要改善保健服务并与社区护理提供者协调，以提高教养环境中艾滋病毒治疗的质量。
Introduction. HIV-positive injection drug users (IDU) often do not derive the full benefits of highly active antiretroviral therapy (HAART). Among IDU, recent incarceration has been associated with discontinuation of HAART for non-clinical reasons. We sought to qualitatively evaluate experiences with HAART among HIV-positive IDU who had been recently incarcerated within provincial prisons in British Columbia in order to identify factors influencing adherence to treatment.Methods. Twelve in-depth qualitative interviews were conducted with males recruited from a cohort study (ACCESS) involving over 450 HIV-positive IDU. All participants had been incarcerated after initiating HAART. Audio-recorded interviews were conducted to examine experiences of taking HAART in prison, with particular attention to adherence and experiences of treatment discontinuation.Findings. Participant accounts described situations where adherence to HIV treatment was compromised in custody. A small number of participants reported treatment interruptions that lasted over a week when they were unable to obtain HIV medications through institutional healthcare. Short-term interruptions in treatment were said to be common during intake into the correctional system and at the point of release from custody. High levels of HIV discrimination motivate prisoners to hide the fact that they are HIV-positive by making efforts to take medications discreetly, which may result in missed doses.Conclusions. The current study identified contextual factors within correctional environments that hinder individuals' ability to adhere to HAART. These findings also indicate that improved health services and coordination with community care providers are needed to enhance the quality of HIV treatment within correctional environments.