Wessinger Matthew H, Hennink Monique M, Kaiser Bonnie N, Mangal Jed P, Gokhale Runa H, Ruchin Lauren, Moanna Abeer, Rimland David, Farber Eugene W, Marconi Vincent C
a Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , USA.
b Global Health Institute , Duke University , Durham , USA.
AIDS Care. 2017 Oct;29(10):1212-1217. doi: 10.1080/09540121.2017.1308465. Epub 2017 Apr 1.
Institutional barriers in HIV primary care settings can contribute substantially to disparities in retention in HIV treatment and HIV-related outcomes. This qualitative study compared the perceptions of clinic experiences of persons living with HIV (PLWH) in a Veterans Affairs HIV primary care clinic setting who were retained in care with the experiences of those who were not retained in care. Qualitative data from 25 in-depth interviews were analyzed to identify facilitators and barriers to retention in HIV care. Results showed that participants not retained in care experienced barriers to retention involving dissatisfaction with clinic wait times, low confidence in clinicians, and customer service concerns. For participants retained in care, patience with procedural issues, confidence in clinicians, and interpersonal connections were factors that enhanced retention despite the fact that these participants recognized the same barriers as those who were not retained in care. These findings can inform interventions aimed at improving retention in HIV care.
艾滋病病毒初级保健机构中的制度障碍在很大程度上会导致艾滋病病毒治疗留存率及艾滋病相关结果方面的差异。这项定性研究比较了退伍军人事务部艾滋病病毒初级保健诊所中坚持接受治疗的艾滋病病毒感染者(PLWH)与未坚持接受治疗者对临床体验的看法。对来自25次深度访谈的定性数据进行了分析,以确定艾滋病病毒护理留存率的促进因素和障碍。结果显示,未坚持接受治疗的参与者在留存方面遇到了障碍,包括对诊所候诊时间不满意、对临床医生信心不足以及对客户服务的担忧。对于坚持接受治疗的参与者来说,尽管他们认识到与未坚持接受治疗者相同的障碍,但对程序问题的耐心、对临床医生的信心以及人际关系是提高留存率的因素。这些发现可为旨在提高艾滋病病毒护理留存率的干预措施提供参考。