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赞比亚高流行城市环境下两种不同社区模式提供抗逆转录病毒治疗的可接受性和偏好：巢式在 HPTN 071（PopART）研究中的整群随机试验。

Acceptability and Preferences of Two Different Community Models of ART Delivery in a High Prevalence Urban Setting in Zambia: Cluster-Randomized Trial, Nested in the HPTN 071 (PopART) Study.

机构信息

Zambart House, School of Medicine, University of Zambia, Ridgeway Campus, Off Nationalist Road, P.O. Box 50697, Lusaka, Zambia.

Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

AIDS Behav. 2022 Feb;26(2):328-338. doi: 10.1007/s10461-021-03385-8. Epub 2021 Jul 24.

DOI:10.1007/s10461-021-03385-8
PMID:34304330
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8813709/
Abstract

Community delivery of Antiretroviral therapy (ART) is a novel innovation to increase sustainable ART coverage for People living with HIV (PLHIV) in resource limited settings. Within a nested cluster-randomised sub-study in two urban communities that participated in the HPTN 071 (PopART) trial in Zambia we investigated individual acceptability and preferences for ART delivery models. Stable PLHIV were enrolled in a cluster-randomized trial of three different models of ART: Facility-based delivery (SoC), Home-based delivery (HBD) and Adherence clubs (AC). Consenting individuals were asked to express their stated preference for ART delivery options. Those assigned to the community models of ART delivery arms could choose ("revealed preference") between the assigned arm and facility-based delivery. In total 2489 (99.6%) eligible individuals consented to the study and 95.6% chose community models of ART delivery rather than facility-based delivery when offered a choice. When asked to state their preference of model of ART delivery, 67.6% did not state a preference of one model over another, 22.8% stated a preference for HBD, 5.0% and 4.6% stated a preference for AC and SoC, respectively. Offering PLHIV choices of community models of ART delivery is feasible and acceptable with majority expressing HBD as their stated preferred option.

摘要

社区提供抗逆转录病毒疗法 (ART) 是一种新颖的创新方法，旨在增加资源有限环境中艾滋病毒感染者 (PLHIV) 可持续接受 ART 治疗的机会。在赞比亚 HPTN 071 (PopART) 试验中参与的两个城市社区的嵌套群组随机亚研究中，我们调查了个人对 ART 提供模式的可接受性和偏好。稳定的 PLHIV 被纳入三种不同 ART 模式的群组随机试验中：医疗机构提供 (SoC)、家庭提供 (HBD) 和依从俱乐部 (AC)。同意参与的个人被要求表达他们对 ART 提供选项的首选意愿。那些被分配到社区 ART 提供模式的人可以在分配的手臂和医疗机构提供之间做出选择（“揭示偏好”）。共有 2489 名（99.6%）符合条件的个人同意参与研究，当提供选择时，95.6%的人选择社区提供的 ART 模式，而不是医疗机构提供。当被要求说明他们对 ART 提供模式的偏好时，67.6%的人没有表示对一种模式的偏好超过另一种模式，22.8%的人表示偏好 HBD，分别有 5.0%和 4.6%的人表示偏好 AC 和 SoC。为 PLHIV 提供社区 ART 提供模式的选择是可行且可接受的，大多数人表示 HBD 是他们首选的方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/767b/8813709/e0c403c8b376/10461_2021_3385_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/767b/8813709/e0c403c8b376/10461_2021_3385_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/767b/8813709/e0c403c8b376/10461_2021_3385_Fig1_HTML.jpg

相似文献

[1]
Acceptability and Preferences of Two Different Community Models of ART Delivery in a High Prevalence Urban Setting in Zambia: Cluster-Randomized Trial, Nested in the HPTN 071 (PopART) Study.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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引用本文的文献

[1]
The Urban Environment and Disparities in Sexual and Reproductive Health Outcomes in the Global South: a Scoping Review.

J Urban Health. 2023-6

[2]
Scaling up access to HIV pre-exposure prophylaxis (PrEP): should nurses do the job?

Lancet HIV. 2022-5

本文引用的文献

[1]
Differentiated Care Preferences of Stable Patients on Antiretroviral Therapy in Zambia: A Discrete Choice Experiment.

J Acquir Immune Defic Syndr. 2019-8-15

[2]
Acceptability of community-based adherence clubs among health facility staff in South Africa: a qualitative study.

Patient Prefer Adherence. 2017-9-11

[3]
Differentiated models of care for postpartum women on antiretroviral therapy in Cape Town, South Africa: a cohort study.

J Int AIDS Soc. 2017-7-21

[4]
Community intervention improves knowledge of HIV status of adolescents in Zambia: findings from HPTN 071-PopART for youth study.

AIDS. 2017-7-1

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What works - reaching universal HIV testing: lessons from HPTN 071 (PopART) trial in Zambia.

AIDS. 2017-7-17

[6]
A universal testing and treatment intervention to improve HIV control: One-year results from intervention communities in Zambia in the HPTN 071 (PopART) cluster-randomised trial.

PLoS Med. 2017-5-2

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Community-Based ART Programs: Sustaining Adherence and Follow-up.

Curr HIV/AIDS Rep. 2016-12

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Challenges in initiating antiretroviral therapy for all HIV-infected people regardless of CD4 cell count.

Infect Dis Poverty. 2016-9-5

[9]
Effectiveness of community-based support for pregnant women living with HIV: a cohort study in South Africa.

AIDS Care. 2016

[10]
What Influences Patients' Decisions When Choosing a Health Care Provider? Measuring Preferences of Patients with Knee Arthrosis, Chronic Depression, or Alzheimer's Disease, Using Discrete Choice Experiments.

Health Serv Res. 2015-12

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