Mooney Alyssa C, Gottert Ann, Khoza Nomhle, Rebombo Dumisani, Hove Jennifer, Suárez Aimée Julien, Twine Rhian, MacPhail Catherine, Treves-Kagan Sarah, Kahn Kathleen, Pettifor Audrey, Lippman Sheri A
Department of Epidemiology and Biostatistics, University of California, San Francisco.
Population Council, Washington, D.C.
AIDS Educ Prev. 2017 Jun;29(3):274-287. doi: 10.1521/aeap.2017.29.3.274.
While South Africa provides universal access to treatment, HIV testing and antiretroviral therapy (ART) uptake remains low, particularly among men. Little is known about community awareness of the effects of treatment on preventing transmission, and how this information might impact HIV service utilization. This qualitative study explored understandings of treatment as prevention (TasP) among rural South African men. Narratives emphasized the know value of ART for individual health, but none were aware of its preventive effects. Many expressed that preventing transmission to partners would incentivize testing, earlier treatment, and adherence in the absence of symptoms, and could reduce the weight of a diagnosis. Doubts about TasP impacts on testing and care included enduring risks of stigma and transmission. TasP information should be integrated into clinic-based counseling for those utilizing services, and community-based education for broader reach. Pairing TasP information with alternative testing options may increase engagement among men reluctant to be seen at clinics.
虽然南非提供普遍的治疗机会，但艾滋病毒检测和抗逆转录病毒疗法（ART）的接受率仍然很低，尤其是在男性中。对于社区对治疗预防传播效果的认识，以及这些信息如何影响艾滋病毒服务的利用情况，人们知之甚少。这项定性研究探讨了南非农村男性对治疗即预防（TasP）的理解。叙述强调了抗逆转录病毒疗法对个人健康的已知价值，但没有人意识到其预防效果。许多人表示，在没有症状的情况下，防止传染给伴侣将激励检测、更早接受治疗和坚持治疗，并可以减轻诊断带来的负担。对治疗即预防对检测和护理影响的疑虑包括耻辱感和传播的持续风险。治疗即预防的信息应纳入为使用服务者提供的基于诊所的咨询中，并纳入社区教育以扩大覆盖面。将治疗即预防的信息与其他检测选项相结合，可能会增加那些不愿在诊所就诊的男性的参与度。
