Kasande Meble, Taremwa Michael, Tusimiirwe Happiness, Lamulatu Kabiite, Amanyire Mark, Nakidde Gladys, Kabami Jane
Faculty of Nursing and Health Sciences, Bishop Stuart University, Mbarara city, Uganda.
Department of Nursing, Kabale University School of Medicine, Kabale, Uganda.
HIV AIDS (Auckl). 2022 Nov 18;14:539-551. doi: 10.2147/HIV.S387190. eCollection 2022.
Community Client-Led ART Delivery groups (CCLADS) were introduced as part of the differentiated service delivery models in 2017 to better serve growing number of HIV patients and reduce unnecessary burden on the HIV care delivery system. However, there is limited evidence on the exact patients' and care providers' experiences and perceptions regarding the CCLADS model of ART delivery. We therefore aimed to explore the experiences and perceptions on CCLADS model from the patient and provider perspectives.
A descriptive qualitative study was conducted at two ART clinics in Southwestern Uganda. We conducted in-depth interviews (IDI) to get a deeper understanding of the patient and providers' perspective regarding the model. Responses from participants were recorded using audio recorders and were translated and transcribed. We used thematic approach to analyze the data.
A total of 20 in depth interviews were conducted, with providers, CCLAD leaders and Adults Living with HIV (ALHIV) to assess the experiences and perceptions to participation among People Living with HIV (PLHIV) enrolled in CCLADS and the care providers. Key themes included benefits, limitations, experiences and perceptions of CCLADS. Benefits to ALHIV included: Longer refills, reduced transport costs, receive drugs in time, peer advice; to providers: time saving, less tiresome and reduced congestion at facility. Barriers included: stigma, limited outreaches, failure to comply. Patients perceived the model positively (cost effective, improved quality care, no missed appointment where as others were negative (blood samples not taken like before). Experiences also included enough time, learnt some activities and good adherence.
Participation in the CCLADS groups provides several benefits to the patient including reduced transport, longer refills and good adherence. Stigma remains a challenge to CCLADS participation, which requires innovative and collaborative strategies from Ministry of Health (MOH) and implementation partners to address in order to sustain CCLADS participation.
社区患者主导的抗逆转录病毒治疗服务小组（CCLADS）于2017年作为差异化服务提供模式的一部分被引入，以更好地服务于日益增多的艾滋病毒患者，并减轻艾滋病毒护理提供系统的不必要负担。然而，关于患者和护理提供者对CCLADS抗逆转录病毒治疗服务模式的确切体验和看法的证据有限。因此，我们旨在从患者和提供者的角度探讨对CCLADS模式的体验和看法。
在乌干达西南部的两家抗逆转录病毒治疗诊所进行了一项描述性定性研究。我们进行了深入访谈（IDI），以更深入地了解患者和提供者对该模式的看法。使用录音机记录参与者的回答，并进行翻译和转录。我们采用主题分析法对数据进行分析。
共进行了20次深入访谈，对象包括提供者、CCLADS负责人和艾滋病毒感染者（ALHIV），以评估参与CCLADS的艾滋病毒感染者（PLHIV）和护理提供者的体验和看法。关键主题包括CCLADS的益处、局限性、体验和看法。对ALHIV的益处包括：更长的药物续方时间、降低交通成本、及时获得药物、同伴建议；对提供者而言：节省时间、不那么繁琐、减少诊所拥挤。障碍包括：耻辱感、外展服务有限、不遵守规定。患者对该模式看法积极（具有成本效益、改善护理质量、没有错过预约），而其他人则持负面看法（不像以前那样采集血样）。体验还包括有足够的时间、学到一些活动以及良好的依从性。
参与CCLADS小组为患者带来了诸多益处，包括减少交通、更长的药物续方时间和良好的依从性。耻辱感仍然是参与CCLADS的一个挑战，这需要卫生部（MOH）和实施伙伴采取创新和协作策略来解决，以维持对CCLADS的参与。
