Community-Based Approach to Designing an AIDS Program for HIV+ Mothers in India

描述(申请人提供)：在印度，估计有510万艾滋病毒携带者；在这些艾滋病毒感染者中，250万是育龄妇女，主要是父母。符合条件的MLH及其子女的抗逆转录病毒治疗(ART)正在缓慢启动；然而，符合抗逆转录病毒治疗条件的MLH的人数远远低于总体目标。对于绝大多数人来说，针对MLH的艾滋病毒相关服务仅限于围产期。不幸的是，传销的持续需求没有得到解决。这些需求涉及艾滋病毒/艾滋病患者的生活挑战，包括应对抗逆转录病毒疗法的副作用、照顾生病的孩子、处理披露艾滋病毒状况的决定以及应对重大的精神健康压力因素。满足这些需求是至关重要的，因为印度的MLH几乎没有自主权或决策权，他们是文盲，几乎没有人有工作。这项为期两年的试验性研究的目标是利用定性方法了解印度MLH面临的感知生活挑战，以及根据选定医疗环境中的卫生保健提供者的信息，了解护理MLH的最佳方法。参与者还将为制定一项实用的、对文化敏感的干预计划做出贡献，该计划将适合MLH及其子女的身体和情感需求。这项先导性研究的目的是：1)通过焦点小组访谈，探索80名MLH在应对艾滋病毒/艾滋病时表现出的优势和面临的挑战，包括接受抗逆转录病毒治疗、患病期间的育儿、处理披露决定，以及促进他们的心理健康；2)描述促进或阻止MLH成功地寻求、获得或维持对自己和他们的孩子的关怀的因素；3)使MLH描述卫生保健提供者可以采用的策略，以支持MLH优化他们和他们孩子的健康和福祉；4)确定MLH希望接受干预计划的形式；以及5)描述卫生保健提供者及其医务主任报告的向MLH及其子女提供此类服务的障碍和促进者。外行语言：这项研究是相关的，因为我们希望从印度感染艾滋病毒的母亲那里学习如何设计一个计划，帮助她们更好地与疾病生活在一起。这些发现将导致未来的资金，以实际开发和测试一个新设计的程序。

DESCRIPTION (provided by applicant): In India, an estimated 5.1 million people are living with HIV; of these HIV-infected individuals, 2.5 million are women of childbearing age, mostly parents. Antiretroviral treatment (ART) is slowly being initiated for eligible MLH and their children; however, the number of eligible MLH on ART is far below the overall target. For the overwhelming majority, HIV-related services for MLH are limited to the perinatal period. Unfortunately, the ongoing needs of MLH are not addressed. These needs relate to the challenges of living with HIV/AIDS, including dealing with side effects of ART, caring for their children while ill, dealing with decisions of disclosure of their HIV status, and coping with significant mental health stressors. Meeting these needs is critical as MLH in India have little autonomy or decision-making power, are illiterate, and few are employed. The goal of this two-year pilot study is to utilize qualitative methodology to gain an understanding of the perceived life challenges faced by MLH in India, and of optimal approaches to care for MLH, as informed by health care providers in the selected medical settings. Participants will also contribute to the development of a practical and culturally sensitive intervention program that will be appropriate for the physical and emotional needs of MLH and their children. The aims of this pilot study are to: 1) Explore via focus group interviews, the perceptions of 80 MLH in terms of strengths they manifest and challenges they face in dealing with HIV/AIDS, including being maintained on ART, parenting while ill, dealing with disclosure decisions, and promoting their mental health; 2) Describe factors that facilitate or prevent MLH from successfully seeking, obtaining, or maintaining care, including ART, for themselves and their children; 3) Enable MLH to describe strategies that health care providers can employ to support MLH in optimizing their health and well-being and that of their children; 4) Determine the format MLH would like to receive the intervention program; and 5) Describe barriers and facilitators reported by the health care providers and their medical director in delivering such services to MLH and their children. Lay Language: This research is relevant as we hope to learn from HIV-infected mothers in India how to design a program to help them live with their illness more optimally. These findings will lead to future funding to actually develop and test a newly designed program.