Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Women's Global Health Imperative, RTI International, Berkeley, California, USA.
AIDS Patient Care STDS. 2022 Oct;36(10):389-395. doi: 10.1089/apc.2022.0087.
In South Africa, less than half of children receiving antiretroviral therapy are virally suppressed. Adherence challenges include poor palatability of drugs and high pill burden. Subcutaneous implants offer a long-acting alternative to daily oral dosing regimens, which may improve outcomes in children living with HIV (CLWH). Qualitative in-depth interviews were conducted with 24 health care providers (HCPs) in Johannesburg, South Africa. Interviews were audio-recorded and transcribed. Data were coded and analyzed using NVivo 12 software and a Grounded Theory approach. Most HCPs welcomed an implant option for CLWH. Perceived benefits included fewer clinic visits, improved adherence, and "normalization" of the lives of CLWH. Concerns included painful insertion and removal, the potential for stigmatization, and caregivers' likely rejection of biodegradable implants. A single, small, non-transparent rod with some flexibility was preferred by most participants. HCP training and early outreach to mitigate potential misinformation about implants and caregivers' fears about biodegradable implants were emphasized. Further engagement with caregivers of CLWH is required and ongoing.
在南非，接受抗逆转录病毒疗法的儿童中，只有不到一半的人病毒得到抑制。药物口感不佳和药物负担过重是导致用药依从性困难的原因。皮下植入物为每日口服治疗方案提供了一种长效替代方案，可能改善艾滋病毒感染者儿童（CLWH）的治疗结局。研究人员在南非约翰内斯堡对 24 名医疗保健提供者（HCPs）进行了定性深入访谈。访谈进行了录音和转录。使用 NVivo 12 软件和扎根理论方法对数据进行编码和分析。大多数 HCPs 对 CLWH 的植入选择表示欢迎。他们认为植入物的好处包括减少就诊次数、提高用药依从性，以及使 CLWH 的生活“正常化”。但也存在一些顾虑，如植入和取出过程疼痛、潜在的污名化问题，以及照顾者可能会拒绝可生物降解的植入物。大多数参与者倾向于使用单一、小而不透明的、具有一定柔韧性的棒状植入物。研究人员强调需要对 HCP 进行培训，并尽早进行宣传，以减轻人们对植入物的误解和照顾者对可生物降解植入物的担忧。还需要与 CLWH 的照顾者进行进一步的接触和沟通。
