乌干达西部一家地区医院的产前诊所中,艾滋病毒阳性妇女接受高效抗逆转录病毒治疗的障碍。
Barriers to accessing highly active antiretroviral therapy by HIV-positive women attending an antenatal clinic in a regional hospital in western Uganda.
机构信息
School of Public Health, University of Alberta, Canada.
出版信息
J Int AIDS Soc. 2010 Sep 23;13:37. doi: 10.1186/1758-2652-13-37.
BACKGROUND
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).
METHODS
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
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.
CONCLUSIONS
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.
背景
本研究旨在描述乌干达卡巴罗莱地区预防母婴传播+(PMTCT+)项目中 HIV 阳性母亲获得并接受高效抗逆转录病毒治疗(HAART)的障碍。
方法
我们的研究是一项使用主题分析的定性描述性探索性研究。采用随机抽样的方法,对参加该项目的 HIV 阳性母亲进行了个体深入访谈(n=45),这些母亲:(a)从未接受过 HAART(n=17);(b)接受过但未回来接受 HAART(n=2);(c)中断或停止 HAART(n=14);(d)目前正在坚持接受 HAART(n=12)。还进行了一次焦点小组讨论,以验证访谈结果。
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,艾滋病毒相关耻辱和对性伴侣隐瞒艾滋病毒状况、在诊所等待时间长以及医院医患互动不佳等问题也成为重大障碍。
结论
需要解决这些艾滋病毒治疗孕妇和产后妇女的障碍,以提高这一人群对 HAART 的接受度和依从性。这将改善她们的生存状况,同时大大减少母婴传播的风险。
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