Southern Africa Labour and Development Research Unit, University of Cape Town, Private Bag Rondebosch, Cape Town, 7701, South Africa.
The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.
AIDS Behav. 2018 Mar;22(3):691-700. doi: 10.1007/s10461-017-1834-2.
Using survey data collected immediately after referral for ART (N = 87), this study examined ART-readiness among individuals (18 years and older) attending a mobile health clinic in South Africa. Most participants reported being very ready (84%) and motivated (85%) to start ART, but only 72% were assessed as ready for ART on all measures. Treatment readiness was lower among individuals who did not think they would test HIV-positive (aOR 0.26, p < 0.05) and among individuals who reported being in good health (aOR 0.44, p < 0.1). In contrast, higher readiness was associated with better ART knowledge (aOR 4.31, p < 0.05) and knowing someone who had experienced positive health effects from ART (aOR 2.65, p < 0.05). Results indicate that post-test counselling will need to be designed to deal with surprise at HIV diagnosis, and that health messaging needs to be carefully crafted to support uptake of ART among HIV-positive but healthy individuals. Further research is needed on effective post-test counselling approaches and effective framing of health messaging to increase awareness of the multiple positive benefits of early ART initiation and corresponding readiness to engage in treatment.
本研究使用在接受抗逆转录病毒治疗（ART）转介后立即收集的调查数据，调查了南非一家移动医疗诊所中接受治疗的（18 岁及以上）个体的接受 ART 治疗的准备情况。大多数参与者报告称他们非常愿意（84%）并积极准备（85%）开始接受 ART 治疗，但只有 72%的人在所有指标上都被评估为准备接受 ART 治疗。对于那些认为自己不会 HIV 阳性检测结果（优势比 0.26，p<0.05）和报告自己身体健康的个体（优势比 0.44，p<0.1），治疗准备程度较低。相比之下，更高的准备程度与更好的 ART 知识（优势比 4.31，p<0.05）和了解有人从 ART 中获得积极健康影响（优势比 2.65，p<0.05）有关。研究结果表明，需要设计 HIV 检测后咨询，以应对 HIV 诊断带来的意外，并精心制定健康信息传递，以支持 HIV 阳性但健康个体接受 ART 治疗。需要进一步研究有效的检测后咨询方法和有效的健康信息传递框架，以提高人们对早期开始 ART 的多种积极益处的认识，并相应提高接受治疗的准备程度。
