Kunapareddy Catherine June, Nyandiko Winstone, Inui Thomas, Ayaya Samwel, Marrero David G, Vreeman Rachel
Indiana University School of Medicine, Department of Public Health, Indianapolis, IN, USA.
Moi University School of Medicine, Department of Child Health and Pediatrics, Eldoret, Kenya, and USAID, Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
J HIV AIDS Soc Serv. 2014 Oct 1;13(4):383-401. doi: 10.1080/15381501.2012.754392. Epub 2014 Nov 1.
Antiretroviral therapy (ART) requires nearly perfect adherence to be effective. This study aims to identify key factors identified by HIV-infected adolescents on ART as contributing to medication adherence in western Kenya. Using a qualitative study design, three adolescent focus groups discussions were conducted at an urban and rural clinic site in western Kenya. The study population included HIV-infected adolescents receiving ART through the USAID-AMPATH HIV care system. A trained facilitator conducted groups in Kiswahili using a semi-structured interview guide probing multiple aspects of experience of taking medicines. Transcribed focus group dialogues were analyzed using constant comparison, progressive coding, and triangulation. The adolescents described a context of negative societal beliefs about HIV, necessitating a lifestyle of secrecy and minimizing the information shared about HIV or ART. Assessing and addressing adolescents' fears and behaviors regarding medication secrecy and disclosure may enable more accurate monitoring of adherence and development of intervention strategies.
抗逆转录病毒疗法（ART）需要几乎完美的依从性才能有效。本研究旨在确定肯尼亚西部接受抗逆转录病毒治疗的感染艾滋病毒青少年所认为的有助于药物依从性的关键因素。采用定性研究设计，在肯尼亚西部的一个城乡诊所地点进行了三次青少年焦点小组讨论。研究人群包括通过美国国际开发署-AMPATH艾滋病毒护理系统接受抗逆转录病毒治疗的感染艾滋病毒青少年。一名经过培训的主持人用斯瓦希里语主持小组讨论，使用半结构化访谈指南探究服药经历的多个方面。对转录的焦点小组对话进行了持续比较、渐进编码和三角验证分析。青少年描述了社会对艾滋病毒存在负面看法的背景，这使得他们需要保持隐秘的生活方式，并尽量减少关于艾滋病毒或抗逆转录病毒疗法的信息共享。评估和解决青少年对药物保密和披露的恐惧及行为，可能有助于更准确地监测依从性并制定干预策略。
