Ajuna Noble, Tumusiime Brian, Amanya Joseph, Awori Sharon, Rukundo Godfrey Z, Asiimwe John Baptist
Department of Nursing, Bishop Stuart University, Mbarara City, Southwestern Uganda.
Department of Psychiatry, Mbarara University of Science and Technology, Mbarara City, Southwestern Uganda.
HIV AIDS (Auckl). 2021 Oct 7;13:939-958. doi: 10.2147/HIV.S328643. eCollection 2021.
Young adults living with HIV (YALWH) struggle to maintain high levels of adherence to antiretroviral therapy (ART) because of numerous barriers. This study describes the social networks of YALWH (18-24 years), their barriers to ART adherence, and the perceived role of social networks in overcoming those barriers.
This study used a qualitative descriptive research design. Twenty-three (23) YALWH who were on ART for a period of greater than one (1) month and had consented to participate in the study were purposively selected from two primary health care facilities in southwestern Uganda. We held four (4) focus group discussions with the YALWH over 5 weeks between the 24th of July and 7th September 2020. Data were audio recorded, transcribed, and entered in Microsoft word 2010. Using the content analysis techniques, data were inductively coded and categories or themes developed.
Most YALWH belonged to bonding (family, friends, and neighbors), followed by bridging (informal groups), and linking (health professionals) social networks, respectively. Most YALWH, irrespective of gender, had close connections with their mothers or elder sisters. The commonest form of bridging networks was informal community groups that provided financial services, whereas the linking ones comprised health professionals' directly involved in HIV patient care such as nurses, counselors, and their affiliates (expert clients or clinic based peer supporters), who occasionally acted as bonding networks. Structural barriers to ART adherence (eg, stigma) were the most cited, followed by medication- (eg, pill burden), and patient-related barriers (eg, non-disclosure of HIV status). Bonding networks were perceived to help overcome patient, medication, and structural barriers to ART adherence. Bridging networks overcame structural and medication-related barriers to ART adherence. Linking networks were perceived to help overcome some health systems and medication-related barriers to ART adherence.
Bonding social networks seem to play a prominent role in overcoming numerous barriers to ART adherence compared with bridging and linking social networks.
感染艾滋病毒的年轻人（YALWH）由于诸多障碍，难以维持对抗逆转录病毒疗法（ART）的高度依从性。本研究描述了18至24岁的YALWH的社交网络、他们在ART依从性方面的障碍，以及社交网络在克服这些障碍中所扮演的角色。
本研究采用定性描述性研究设计。从乌干达西南部的两个初级卫生保健机构中，有目的地选取了23名接受ART治疗超过1个月且同意参与研究的YALWH。在2020年7月24日至9月7日的5周内，我们与YALWH进行了4次焦点小组讨论。数据进行了音频录制、转录，并录入Microsoft word 2010。使用内容分析技术，对数据进行归纳编码，并形成类别或主题。
大多数YALWH分别属于紧密型（家人、朋友和邻居）、桥接型（非正式团体）和连接型（卫生专业人员）社交网络。大多数YALWH，无论性别，都与他们的母亲或姐姐关系密切。桥接网络最常见的形式是提供金融服务的非正式社区团体，而连接网络则由直接参与艾滋病毒患者护理的卫生专业人员组成，如护士、咨询师及其附属人员（专家客户或基于诊所的同伴支持者），他们偶尔也充当紧密型网络。ART依从性的结构障碍（如耻辱感）被提及最多，其次是药物相关障碍（如服药负担）和患者相关障碍（如不披露艾滋病毒感染状况）。紧密型网络被认为有助于克服患者、药物和ART依从性的结构障碍。桥接网络克服了ART依从性的结构和药物相关障碍。连接网络被认为有助于克服一些卫生系统和药物相关的ART依从性障碍。
与桥接型和连接型社交网络相比，紧密型社交网络似乎在克服ART依从性的众多障碍方面发挥着重要作用。
