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在高收入环境中,感染艾滋病毒的女性作为少数群体,在获得治疗和保持治疗连续性方面存在障碍。

The barriers to linkage and retention in care for women living with HIV in an high income setting where they comprise a minority group.

作者信息

Giles M L, MacPhail A, Bell C, Bradshaw C S, Furner V, Gunathilake M, John M, Krishnaswamy S, Martin S J, Ooi C, Owen L, Russell D, Street A, Post J J

机构信息

a Department of Infectious Diseases , Alfred Health , Melbourne , Australia.

b Department of Obstetrics and Gynecology , Monash University , Melbourne , Australia.

出版信息

AIDS Care. 2019 Jun;31(6):730-736. doi: 10.1080/09540121.2019.1576843. Epub 2019 Feb 12.


DOI:10.1080/09540121.2019.1576843
PMID:30754996
Abstract

Women comprise a minority population of individuals living with HIV in Australia, and are often poorly represented in research and clinical trials so their needs remain largely unknown. Data suggests that they are diagnosed later than men and start antiretroviral therapy at a lower CD4 cell count. This raises the question whether there are sex specific barriers to linkage and retention in care. This study analyzed 484 surveys received from clinicians collecting demographic, virological, and reproductive health data along with perceived barriers to linkage and retention in care. Most women (67%) were estimated to have been linked into care within 28 days of diagnosis. For women who were not linked into care for more than 28 days, the most commonly reason cited was fear of disclosure to others, followed by fear of disclosure to their partner. The main reasons given for non-retention in care were related to transport, carer responsibilities, financial pressure, health beliefs and concern about stigma or disclosure.

摘要

在澳大利亚,感染艾滋病毒的女性占少数群体,她们在研究和临床试验中的代表性往往不足,因此她们的需求在很大程度上仍不为人所知。数据表明,她们比男性确诊时间晚,且在CD4细胞计数较低时才开始抗逆转录病毒治疗。这就引发了一个问题,即护理衔接和持续护理方面是否存在性别特异性障碍。本研究分析了从临床医生那里收到的484份调查问卷,这些问卷收集了人口统计学、病毒学和生殖健康数据,以及护理衔接和持续护理方面的感知障碍。估计大多数女性(67%)在确诊后28天内已与护理机构建立联系。对于超过28天未与护理机构建立联系的女性,最常被提及的原因是害怕向他人透露病情,其次是害怕向伴侣透露病情。护理不持续的主要原因与交通、护理责任、经济压力、健康观念以及对耻辱感或透露病情的担忧有关。

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引用本文的文献

[1]
Barriers to Retention in Care among Adults with HIV in Developed Countries: An Integrative Review.

AIDS Behav. 2025-4-5

[2]
A Trauma-Informed HIV Intervention (LinkPositively) to Improve HIV Care Among Black Women Affected by Interpersonal Violence: Protocol for a Pilot Randomized Controlled Trial.

JMIR Res Protoc. 2023-7-5

[3]
County-level variations in linkage to care among people newly diagnosed with HIV in South Carolina: A longitudinal analysis from 2010 to 2018.

PLoS One. 2023

[4]
: A Trauma-Informed Peer Navigation and Social Networking WebApp to Improve HIV Care among Black Women Affected by Interpersonal Violence.

J Health Care Poor Underserved. 2021-5

[5]
Differential Role of Psychosocial, Health Care System and Neighborhood Factors on the Retention in HIV Care of Women and Men in the Ryan White Program.

J Int Assoc Provid AIDS Care. 2020

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