HIV service delivery in the time of COVID-19: focus group discussions with key populations in India.
HIV service delivery in the time of COVID-19: focus group discussions with key populations in India.
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Covid-19时期的HIV服务提供：与印度关键人群进行焦点小组讨论。
DOI：
10.1002/jia2.25800
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发表时间：
2021-10
影响因子：
6
通讯作者：
Solomon SS
中科院分区：
文献类型：
--
作者：
Pollard R;Gopinath U;Reddy YA;Kumar BR;Mugundu P;Vasudevan CK;Srikrishnan AK;Singh A;McFall AM;Mayer KH;Mehta SH;Solomon SS
关于COVID-19相关中断和新型艾滋病毒服务提供策略对低收入和中等收入国家关键人群（KPs）的影响，数据有限。于二零二零年三月，为应对COVID-19，印度政府修订了艾滋病毒服务提供政策，以包括向所有艾滋病毒感染者（PLHIV）提供社区抗逆转录病毒疗法（ART）分配和多月分配（MMD）ART。为了评估这些适应措施的可接受性以及KPs对疫情的影响，我们于2020年11月至12月对特兰加纳和马哈拉施特拉邦的男男性行为者（MSM）、女性性工作者（FSW）和跨性别女性（TGW）进行了专题小组调查。进行了七次讨论。主题包括艾滋病毒服务的获得、风险行为、经济保障和确保服务连续性的反馈。归纳编码确定了各个主题的主题。44名年龄在20-49岁之间的人参加了讨论（13名MSM; 16名FSW;和15名TGW）。24名参与者自我认定为艾滋病毒感染者。未感染艾滋病毒的人报告说，由于旅行限制和担心感染COVID-19，他们在医院接受艾滋病毒抗体检测方面面临挑战。参与者在封锁解除后使用社区组织安排的交通工具进行艾滋病毒抗体检测。艾滋病毒感染者报告了不间断的抗逆转录病毒药物补充和总体一致的依从性;然而，也有延迟CD 4和艾滋病毒RNA检测的经历。与会者对MMD表示赞赏，因为它节省了时间，金钱，并减少了COVID-19的风险。与会者对家庭分娩表示感谢，使人们能够获得抗逆转录病毒治疗，但对家庭服务导致家庭/邻居违反保密规定表示担忧。与公立医院相比，参与者表示更喜欢以社区为基础的服务提供，因为它们距离近，时间方便，环境友好。其他要求包括支持收入，就业，营养丰富的食物和更容易获得的心理健康，艾滋病毒和其他卫生服务。与ART获取相比，COVID-19限制对获得HIV抗体、CD 4和RNA检测服务的影响更大。对MMD和社区服务的高度接受支持了差异化服务提供模式的持续作用，以改善KP获得艾滋病毒抗体，CD 4，RNA检测服务，方便的ART检索以及艾滋病毒以外的综合服务，这可能对生存和福祉至关重要。
There are limited data on the impact of COVID‐19‐associated disruptions and novel HIV service delivery strategies among key populations (KPs) in low‐ and middle‐income countries. In March 2020, in response to COVID‐19, the Government of India revised HIV service delivery policies to include community antiretroviral therapy (ART) distribution and multi‐month dispensing (MMD) of ART for all people living with HIV (PLHIV). To assess the acceptability of these adaptations and impact of the pandemic among KPs, we conducted focus groups in November–December 2020 with purposively sampled men who have sex with men (MSM), female sex workers (FSWs) and transgender women (TGW) in Telangana and Maharashtra. Seven discussions were conducted. Topics included HIV service access, risk behaviours, economic security and feedback to ensure service continuity. Inductive coding identified themes across topics. Forty‐four individuals aged 20–49 years participated in discussions (13 MSM; 16 FSW; and 15 TGW). Twenty‐four participants self‐identified as living with HIV. People not living with HIV reported challenges in accessing HIV antibody testing at hospitals due to travel restrictions and fear of contracting COVID‐19. Participants accessed HIV antibody testing using transportation arranged by community‐based organizations after lockdowns eased. PLHIV reported uninterrupted ART refills and generally consistent adherence; however, there were experiences of delayed CD4 and HIV RNA testing. Participants shared appreciation for MMD as it saved time, money, and reduced exposure to COVID‐19. Participants expressed gratitude for home deliveries which enabled ART access, yet shared concerns about home‐based services causing confidentiality breaches with family/neighbours. Participants voiced preferences for community‐based service provision due to proximity, convenient hours, and welcoming environments compared to public hospitals. Other requests included support for income, employment, nutrient‐rich food and more accessible mental health, HIV, and other health services. COVID‐19 restrictions had a greater impact on access to HIV antibody, CD4, and RNA testing services compared to ART access. High acceptance of MMD and community‐based services support the continued role of differentiated service delivery models to improve KP access to HIV antibody, CD4, RNA testing services, convenient ART retrieval, and integrated services beyond HIV, which may be critical for survival and wellbeing.
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呼吁差异化方法向关键人群提供艾滋病毒服务。
影响因子：
6
作者：
Macdonald V;Verster A;Baggaley R
通讯作者：
Baggaley R
DOI：
10.1016/s2352-3018(20)30359-3
发表时间：
2021-03
期刊：
The lancet. HIV
影响因子：
--
作者：
Dorward J;Khubone T;Gate K;Ngobese H;Sookrajh Y;Mkhize S;Jeewa A;Bottomley C;Lewis L;Baisley K;Butler CC;Gxagxisa N;Garrett N
通讯作者：
Garrett N
影响因子：
4.4
作者：
Stephenson, Rob;Chavanduka, Tanaka M. D.;Rogers, Erin
通讯作者：
Rogers, Erin
影响因子：
3.6
作者：
Hyndman, Iain;Nugent, Diarmuid;Girometti, Nicolo
通讯作者：
Girometti, Nicolo
影响因子：
4.4
作者：
Sanchez, Travis H.;Zlotorzynska, Maria;Baral, Stefan D.
通讯作者：
Baral, Stefan D.