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像感染前一样生活:海地10年存活期HIV感染者的定性研究

Live with the Disease Like You Used to Before You Knew You Were Infected: A Qualitative Study Among 10-Year Survivors Living with HIV in Haiti.

作者信息

Pierre Samuel, Riviera Vanessa, Jean Circee Phara, Louis Marie Jude Jean, Reif Lindsey K, Severe Patrice, Rouzier Vanessa, Johnson Warren D, Pape Jean W, Fitzgerald Daniel W, McNairy Margaret L, Boutin-Foster Carla

机构信息

1 Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections , GHESKIO, Port-au-Prince, Haiti .

2 Center for Global Health , Weill Cornell Medical College, New York, New York.

出版信息

AIDS Patient Care STDS. 2017 Mar;31(3):145-151. doi: 10.1089/apc.2016.0192.

Abstract

In 2003, the Haitian Study Group on Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), a nonprofit organization, began administering antiretroviral therapy (ART) to its patients. This practice transformed HIV from a fatal disease to a more manageable chronic condition. However, relatively few studies focus on the experiences of survivors. This study provided a unique opportunity to interview patients who survived at least 10 years after being treated with ART at GHESKIO. The goal of the study was to elicit from patients their perspectives on what enabled them to survive with AIDS. Grounded Theory, a qualitative research method was used to guide data collection, coding, and analysis. Individual interviews were conducted, audio-taped, transcribed and analyzed in Creole, and translated into English. Data saturation was reached at 25 participants. Of which, 64% were women, the mean age was 49, range of 43-55 years, 24% were married, 44% had not completed elementary school, and 72% had no income, the remaining participants had incomes ranging from $1000 to $5000 annually. Qualitative analysis resulted in 681 codes, which were grouped into six categories: being spiritually grounded, having supportive interactions with providers, caring for children, setting personal goals, persevering and living life as usual, and maintaining strict medication adherence practices. The overarching theory was that having a reason to live despite one's circumstances and living life as usual enabled one to survive. Having a strong spiritual foundation coupled with supportive family and providers motivated participants to live and adhere to their ART. As the number of patients who are living longer with HIV in Haiti increases, results from this study will be important in helping tailor interventions that enhance their overall quality of life.

摘要

2003年,非营利组织海地卡波西肉瘤与机会性感染研究小组(GHESKIO)开始为其患者提供抗逆转录病毒疗法(ART)。这种做法将艾滋病从一种致命疾病转变为一种更易控制的慢性病。然而,相对较少的研究关注幸存者的经历。这项研究提供了一个独特的机会,对在GHESKIO接受抗逆转录病毒治疗后存活至少10年的患者进行访谈。该研究的目的是从患者那里了解使他们在感染艾滋病后存活下来的因素。扎根理论这一定性研究方法被用于指导数据收集、编码和分析。进行了个人访谈,用克里奥尔语进行录音、转录和分析,然后翻译成英语。25名参与者达到了数据饱和。其中,64%为女性,平均年龄为49岁,年龄范围在43至55岁之间,24%已婚,44%未完成小学教育,72%没有收入,其余参与者的年收入在1000美元至5000美元之间。定性分析产生了681个编码,这些编码被归为六类:有精神寄托、与医护人员有支持性互动、照顾孩子、设定个人目标、坚持不懈并照常生活、严格坚持药物治疗。总体理论是,无论身处何种环境都有活下去的理由并照常生活使人能够存活。拥有强大的精神基础以及支持性的家庭和医护人员激励参与者活下去并坚持接受抗逆转录病毒治疗。随着海地感染艾滋病后存活时间更长的患者数量增加,这项研究的结果对于帮助制定提高他们总体生活质量的干预措施将具有重要意义。

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