Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
AIDS Patient Care STDS. 2013 Jul;27(7):408-15. doi: 10.1089/apc.2012.0434.
Self-determination theory examines the needs of people adopting new behaviors but has not been applied to the adoption of HIV healthcare behaviors. The current study applied self-determination theory to descriptions of healthcare behaviors adopted by ethnic minority women after an HIV diagnosis. Women of color were asked to describe their experiences with HIV testing, entry, and engagement-in-care in qualitative interviews and focus groups. Participants were mostly African-American (88%), over 40 years old (70%), had been diagnosed for more than 6 years (87%) and had disclosed their HIV infection to more than 3 people (73%). Women described unmet self-determination needs at different time points along the HIV Continuum of Care. Women experienced a significant loss of autonomy at the time of HIV diagnosis. Meeting competency and relatedness needs assisted women in entry and engagement-in-care. However, re-establishing autonomy was a key element for long-term engagement-in-care. Interventions that satisfy these needs at the optimal time point in care could improve diagnosis, entry-to-care, and retention-in-care for women living with HIV.
自我决定理论探讨了人们采用新行为的需求，但尚未应用于 HIV 保健行为的采用。本研究将自我决定理论应用于描述少数民族妇女在 HIV 诊断后的保健行为。在定性访谈和焦点小组中，要求有色人种妇女描述她们的 HIV 检测、进入和参与护理的经历。参与者主要是非洲裔美国人（88%），年龄在 40 岁以上（70%），被诊断出患有 HIV 超过 6 年（87%），并向超过 3 人透露了他们的 HIV 感染情况（73%）。妇女在 HIV 护理连续体的不同时间点描述了未满足的自我决定需求。妇女在 HIV 诊断时经历了自主权的重大丧失。满足能力和关联性需求有助于妇女进入和参与护理。然而，重新获得自主权是长期参与护理的关键因素。在护理的最佳时间点满足这些需求的干预措施可以改善 HIV 感染者的诊断、进入护理和保留率。
