参与 HIV 护理连续体的非裔美国男男性行为者面临的障碍和促进因素：基于理论的定性研究。
Barriers and Facilitators to Engaging African American Men Who Have Sex With Men in the HIV Care Continuum: A Theory-Based Qualitative Study.
机构信息
John B. Jemmott, III, PhD, is a Professor, Perelman School of Medicine and Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Jingwen Zhang, PhD, is an Assistant Professor, Department of Communication, University of California, Davis, Davis, California, USA. Mikia Croom, MSEd, is a Senior Research Coordinator, Center for Health Behavior & Communication Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Larry D. Icard, PhD, is a Professor, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA. Scott E. Rutledge, PhD, is an Associate Professor, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA. Ann O'Leary, PhD, is a Senior Behavioral Scientist, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
出版信息
J Assoc Nurses AIDS Care. 2019 May-Jun;30(3):352-361. doi: 10.1097/JNC.0000000000000087.
African American men who have sex with men (MSM) have high rates of HIV, but interventions are needed to address their low rates of engagement in the HIV care continuum. To identify modifiable factors potentially affecting such engagement, we conducted qualitative interviews guided by the Theory of Planned Behavior with 27 African American MSM who had participated in an HIV risk-reduction intervention trial. Qualitative analyses resulted in four overarching themes: stigma, concerns with health care providers (HCPs), social support, and logistical issues. Facilitators of care continuum engagement included reassurance about health, feeling and looking better, receiving treatment, avoiding infecting others, good relations with HCP, and social support. Barriers included HIV stigma, concerns about confidentiality, negative perceptions of HCP, convenience and availability of testing/treatment facilities, cost, and lack of social support. Efforts to improve African American MSM HIV care continuum engagement should focus on individual and health care system changes.
美国非洲裔男性男同性恋者（MSM）的 HIV 感染率很高，但需要采取干预措施来提高他们参与 HIV 护理连续体的比例。为了确定可能影响这种参与的可改变因素，我们对 27 名参与 HIV 风险降低干预试验的美国非洲裔 MSM 进行了基于计划行为理论的定性访谈。定性分析产生了四个总体主题：耻辱感、对医疗保健提供者（HCP）的担忧、社会支持和后勤问题。促进护理连续体参与的因素包括对健康的保证、感觉和看起来更好、接受治疗、避免感染他人、与 HCP 的良好关系和社会支持。障碍包括 HIV 耻辱感、对保密性的担忧、对 HCP 的负面看法、检测/治疗设施的便利性和可用性、成本和缺乏社会支持。提高美国非洲裔 MSM HIV 护理连续体参与的努力应侧重于个人和医疗保健系统的改变。
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