Barriers to accessing highly active antiretroviral therapy by HIV-positive women attending an antenatal clinic in a regional hospital in western Uganda.

Barriers to accessing highly active antiretroviral therapy by HIV-positive women attending an antenatal clinic in a regional hospital in western Uganda.
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DOI:
10.1186/1758-2652-13-37
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发表时间:
2010-09-23
影响因子:
6
通讯作者:
Okech-Ojony J
Okech-Ojony J
中科院分区:
医学1区
文献类型:
--
作者:
Duff P;Kipp W;Wild TC;Rubaale T;Okech-Ojony J

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本研究的目的是描述乌干达卡巴罗莱区预防母婴传播方案(PMTCT-Plus)中艾滋病毒阳性母亲获得和接受高效抗逆转录病毒治疗(HAART)的障碍。本研究是一项定性描述性探索性研究,采用主题分析法。对随机选择的参加该方案的艾滋病毒阳性母亲进行了个人深入访谈(n = 45),这些母亲:(a)从未参加过HAART(n = 17);(B)参加过但没有回来接受HAART(n = 2);(c)默认/中断HAART(n = 14);(d)目前坚持HAART(n = 12)。还进行了一个焦点小组,以核实访谈结果。结果表明,经济问题,特别是从住所到诊所的交通费用,是获得治疗的最大障碍。此外,与艾滋病毒有关的耻辱感和不向客户的性伴侣透露艾滋病毒状况、在诊所等待时间长以及医院提供者与患者之间的互动欠佳,都成为重大障碍。需要解决孕妇和产后妇女接受抗逆转录病毒治疗的这些障碍,以提高这一人群接受高效抗逆转录病毒治疗的能力和坚持治疗的能力。这将提高她们的生存率,同时大大减少艾滋病毒的母婴传播。
The aim of this study was to describe barriers to accessing and accepting highly active antiretroviral therapy (HAART) by HIV-positive mothers in the Ugandan Kabarole District's Programme for the Prevention of Mother to Child Transmission-Plus (PMTCT-Plus). Our study was a qualitative descriptive exploratory study using thematic analysis. Individual in-depth interviews (n = 45) were conducted with randomly selected HIV-positive mothers who attended this programme, and who: (a) never enrolled in HAART (n = 17); (b) enrolled but did not come back to receive HAART (n = 2); (c) defaulted/interrupted HAART (n = 14); and (d) are currently adhering to HAART (n = 12). A focus group was also conducted to verify the results from the interviews. Results indicated that economic concerns, particularly transport costs from residences to the clinics, represented the greatest barrier to accessing treatment. In addition, HIV-related stigma and non-disclosure of HIV status to clients' sexual partners, long waiting times at the clinic and suboptimal provider-patient interactions at the hospital emerged as significant barriers. These barriers to antiretroviral treatment of pregnant and post-natal women need to be addressed in order to improve HAART uptake and adherence for this group of the population. This would improve their survival and, at the same time, drastically reduce HIV transmission from mother to child.
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