Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA.
J Assoc Nurses AIDS Care. 2011 Mar-Apr;22(2):90-9. doi: 10.1016/j.jana.2010.06.002. Epub 2010 Aug 5.
Delayed entry into HIV clinical care and poor retention during care has been associated with increased morbidity and mortality. To characterize the reasons for patients who eventually did enter HIV care after a delay and/or returned to care after a gap of 6 months or more, 130 semi-structured interviews about barriers to and facilitators for prompt entry into and sustained HIV clinical care were conducted in a clinic setting in the Deep South; responses were coded and analyzed quantitatively. Barriers or facilitators were positioned within superordinate categories of personal and structural barriers or facilitators and denial. Personal barriers for entry into care outweighed structural barriers, with denial being reported by 74% of the sample. Barriers to retention in care were more evenly distributed between personal and structural barriers, with denial being a barrier for 24%. Because of the high incidence of denial-based barriers, the role of this barrier and its resolution should be explored further.
延迟进入 HIV 临床护理以及在护理过程中保留率低与发病率和死亡率的增加有关。为了描述在延迟后最终进入 HIV 护理和/或在 6 个月或更长时间的间隔后返回护理的患者的原因，在南部深处的一个诊所环境中进行了 130 次关于及时进入和持续 HIV 临床护理的障碍和促进因素的半结构化访谈；对回答进行了编码和定量分析。障碍或促进因素被置于个人和结构障碍或促进因素以及否认的上级类别中。进入护理的个人障碍超过了结构障碍，样本中有 74%的人报告了否认。保留在护理中的障碍在个人和结构障碍之间分布更为均匀，否认是障碍的 24%。由于基于否认的障碍发生率很高，因此应进一步探讨这种障碍及其解决办法。
