Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Africa Health Research Institute, KwaZulu-Natal, Durban, KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), Durban, South Africa.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Int J Tuberc Lung Dis. 2020 Apr 1;24(4):396-402. doi: 10.5588/ijtld.18.0740.
There has been slow uptake of isoniazid preventive therapy (IPT) among people living with HIV (PLWH). We surveyed adults recently diagnosed with HIV in 14 South African primary health clinics. Based on the literature and qualitative interviews, sixteen potential barriers and facilitators related to preventive therapy among PLWH were selected. Best-worst scaling (BWS) was used to quantify the relative importance of the attributes. BWS scores were calculated based on the frequency of participants' selecting each attribute as the best or worst among six options (across multiple choice sets) and rescaled from 0 (always selected as worst) to 100 (always selected as best) and compared by currently receiving IPT or not. Among 342 patients surveyed, 33% ( = 114) were currently taking IPT. Having the same standard of life as someone without HIV was most highly prioritized (BWS score = 67.3, SE = 0.6), followed by trust in healthcare providers (score, 66.3 ± 0.6). Poor standard of care in public clinics (score, 30.6 ± 0.6) and side effects of medications (score, 33.7 ± 0.6) were least prioritized. BWS scores differed by IPT status for few attributes, but overall ranking was similar (spearman's rho = 0.9). Perceived benefits of preventive therapy were high among PLWH. IPT prescription by healthcare providers should be encouraged to enhance IPT uptake among PLWH.
在感染艾滋病毒（HIV）的人群中，异烟肼预防治疗（IPT）的采用率一直很低。我们调查了南非 14 家初级保健诊所最近诊断出的成年人 HIV 患者。根据文献和定性访谈，选择了与 PLWH 预防治疗相关的 16 个潜在障碍和促进因素。最佳最差评分（BWS）用于量化属性的相对重要性。BWS 评分是根据参与者在六个选项（多项选择集）中选择每个属性为最佳或最差的频率计算得出的，从 0（始终选择为最差）到 100（始终选择为最佳）进行重新缩放，并根据目前是否接受 IPT 进行比较。在接受调查的 342 名患者中，33%（=114）正在服用 IPT。与没有 HIV 的人拥有相同的生活标准是最重要的（BWS 得分为 67.3，SE = 0.6），其次是对医疗保健提供者的信任（得分为 66.3 ± 0.6）。公共诊所的医疗服务水平差（得分为 30.6 ± 0.6）和药物副作用（得分为 33.7 ± 0.6）是最不重要的。很少有属性的 BWS 评分因 IPT 状态而异，但总体排名相似（斯皮尔曼 rho = 0.9）。PLWH 对预防治疗的益处有很高的认识。应鼓励医疗保健提供者开出 IPT 处方，以提高 PLWH 对 IPT 的采用率。
