O'Laughlin Kelli N, Rouhani Shada A, Kasozi Julius, Greenwald Kelsy E, Perkons Nicholas R, Faustin Zikama M, Bassett Ingrid V, Ware Norma C
1Division of International Emergency Medicine and Humanitarian Programs, Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115 USA.
2Medical Practice Evaluation Center, Department of Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA 02114 USA.
Confl Health. 2018 Mar 12;12:7. doi: 10.1186/s13031-018-0145-1. eCollection 2018.
Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART).
To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART ( = 73) and HIV clinic staff ( = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data.
Refugees described profound motivation to adhere to ART and employed adherence strategies to facilitate success despite the austere setting. However, refugees spoke of specific hardships living in Nakivale that served as barriers to ART adherence, including difficulty accessing clinic when ill, food insecurity, drug stockouts, and violence and unrest in the settlement. For some refugees, need for ART inextricably linked them to the HIV clinic and prevented them from transitioning permanently away from the settlement.
By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country.
撒哈拉以南非洲地区的艾滋病毒感染难民面临着独特的困难，这可能会增加他们抗逆转录病毒治疗（ART）中断的易感性。
为了调查难民坚持接受抗逆转录病毒治疗的经历，我们于2011年3月至7月在乌干达西南部的纳基瓦莱难民营对接受抗逆转录病毒治疗的难民（n = 73）和艾滋病毒诊所工作人员（n = 4）进行了面对面访谈。三名分析人员采用传统的内容分析方法对这些数据进行评估。
难民们表示有强烈的动机坚持接受抗逆转录病毒治疗，尽管环境艰苦，但仍采用坚持策略以确保成功。然而，难民们谈到了在纳基瓦莱生活的一些具体困难，这些困难成为了坚持接受抗逆转录病毒治疗的障碍，包括生病时难以前往诊所、粮食无保障、药品短缺以及难民营中的暴力和动荡。对一些难民来说，对抗逆转录病毒治疗的需求使他们与艾滋病毒诊所紧密相连，阻碍了他们永久离开难民营。
通过了解难民的经历，我们可以设计出明智的干预措施，以提高对抗逆转录病毒治疗的坚持程度，从而将发病率和死亡率降至最低，预防艾滋病毒传播，并支持难民自由地朝着遣返、重新安置或融入所在国的方向发展。
