Rural AIDS and Development Action Research, University of Witwatersrand, Johannesburg, South Africa.
AIDS Behav. 2011 May;15(4):842-52. doi: 10.1007/s10461-010-9747-3.
In some societies, medical pluralism has been demonstrated to delay access to care. We identified sources of health care, and explored utilization patterns and triggers of care-seeking behavior among HIV/AIDS patients in rural South Africa. A longitudinal qualitative study consisting of in-depth interviews was conducted. We purposively sampled thirty-two adult HIV clinic attendees. A high degree of medical pluralism occurred among participants before initiation of antiretroviral treatment (ART). After ART initiation, participants predominantly used the HIV/ART clinic, and utilization of private and traditional facilities decreased. Patterns included both concurrent and sequential pathways to public, private and traditional health sectors. HIV diagnosis and treatment were delayed despite early contact with health systems. Therefore, use of multiple health care modalities before ART initiation can lead to delayed HIV testing and ART initiation. Integrated-care has the potential to mitigate the impact of medical pluralism on access to HIV-related services over the longer term.
在一些社会中，医学多元化已被证明会延迟获得医疗服务的机会。我们确定了医疗保健的来源，并探讨了南非农村地区艾滋病毒/艾滋病患者的利用模式和寻求医疗服务的触发因素。这是一项纵向定性研究，包括深入访谈。我们有目的地选取了 32 名成年艾滋病毒诊所就诊者。在开始接受抗逆转录病毒治疗（ART）之前，参与者中存在高度的医学多元化现象。在开始接受 ART 后，参与者主要使用艾滋病毒/艾滋病诊所，对私人和传统设施的利用减少。模式包括同时和顺序进入公共、私人和传统卫生部门的途径。尽管很早就接触了卫生系统，但艾滋病毒的诊断和治疗仍被延迟。因此，在开始接受 ART 之前使用多种医疗保健模式可能导致 HIV 检测和 ART 启动的延迟。长期来看，综合护理有可能减轻医学多元化对获得艾滋病毒相关服务的影响。
