McKinney Ogbochi, Modeste Naomi N, Lee Jerry W, Gleason Peter C, Maynard-Tucker Gisele
School of Public Health, Loma Linda University, 24951 North Circle Drive, Nichol Hall, Loma Linda, CA 92350, USA.
University of California Los Angeles (UCLA) Center for the Study of Women, Los Angeles, CA 90095, USA.
AIDS Res Treat. 2014;2014:489370. doi: 10.1155/2014/489370. Epub 2014 Dec 28.
Background. The purpose of this study was to explore healthcare providers' perspectives on antiretroviral (ART) adherence in two ART clinics in southern Malawi. Nonadherence to ART is a significant hindrance to the success of HIV/AIDS treatment. Methods. A one-on-one semistructured interview was conducted with eight healthcare providers in two ART clinics in rural and urban southern Malawi. The interviews were focused on factors facilitating or hindering ART adherence and strategies to improve adherence. Interviews were audio-recorded, transcribed, and content-analyzed with the use of the constant comparison approach. Results. Of the eight participants, 63% were between the ages of 20 and 30 years and 37% were HIV counselors. Factors facilitating adherence include patients' belief and knowledge, HIV/AIDS education, and a supportive network. Barriers to adherence include discrimination, nondisclosure of HIV status, food insecurity, medication side effects, religion, misinformation, and staff and drug shortages. Strategies to improve adherence were identified by participants to include nutritional/food supplementation for malnourished or undernourished patients and patient counseling. Conclusions. There is a need for collaborative efforts between healthcare providers, patients, and faith-based organizations to identify and address hindrances and facilitators to patients' adherence. Further research is needed to develop strategies addressing religion, staff, and drug shortages.
背景。本研究的目的是探讨马拉维南部两家抗逆转录病毒治疗（ART）诊所的医疗服务提供者对ART依从性的看法。不坚持ART是艾滋病毒/艾滋病治疗成功的重大障碍。方法。对马拉维南部农村和城市的两家ART诊所的八名医疗服务提供者进行了一对一的半结构化访谈。访谈重点关注促进或阻碍ART依从性的因素以及提高依从性的策略。访谈进行了录音、转录，并采用持续比较法进行内容分析。结果。在八名参与者中，63%的年龄在20至30岁之间，37%是艾滋病毒咨询员。促进依从性的因素包括患者的信念和知识、艾滋病毒/艾滋病教育以及支持网络。依从性的障碍包括歧视、不披露艾滋病毒感染状况、粮食不安全、药物副作用、宗教、错误信息以及工作人员和药品短缺。参与者确定的提高依从性的策略包括为营养不良或营养不足的患者提供营养/食物补充以及患者咨询。结论。医疗服务提供者、患者和基于信仰的组织之间需要共同努力，以识别和解决患者依从性的障碍和促进因素。需要进一步研究以制定解决宗教、工作人员和药品短缺问题的策略。
