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

描述（由申请人提供）：在印度，估计有510万人感染艾滋病毒；在这些感染艾滋病毒的人中，有250万是育龄妇女，其中大多数是父母。抗逆转录病毒治疗（ART）正在缓慢地为符合条件的产妇及其子女启动；然而，接受抗逆转录病毒治疗的合格产妇人数远远低于总体目标。对绝大多数人来说，与艾滋病毒有关的妇幼保健服务仅限于围产期。不幸的是，MLH的持续需求没有得到解决。这些需求与感染艾滋病毒/艾滋病的挑战有关，包括处理抗逆转录病毒治疗的副作用、照顾生病的子女、处理披露其艾滋病毒状况的决定，以及处理严重的精神健康压力源。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，很少有工作。这项为期两年的试点研究的目标是利用定性方法来了解印度MLH面临的感知生活挑战，以及在选定的医疗机构中由卫生保健提供者告知的MLH护理的最佳方法。参与者还将为制定一个实用的、具有文化敏感性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。本试点研究的目的是：1)通过焦点小组访谈，探讨80名MLH在处理艾滋病毒/艾滋病方面表现出的优势和面临的挑战，包括继续接受抗逆转录病毒治疗、生病时养育子女、处理披露决定和促进心理健康；2)描述促进或阻止产妇为自己和子女成功寻求、获得或维持护理（包括抗逆转录病毒治疗）的因素；3)使妇幼保健院能够描述卫生保健提供者可采用的战略，以支持妇幼保健院优化其健康和福祉及其子女的健康和福祉；4)确定MLH希望接受干预方案的格式；5)描述卫生保健提供者及其医疗主任报告的向母婴健康中心及其子女提供此类服务的障碍和促进因素。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方案，以帮助她们更好地与疾病共存。这些发现将导致未来的资金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.