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应对 HIV 感染者非艾滋病合并症的挑战:患者和医疗保健提供者的观点和经验。

The challenge of dealing with non-AIDS comorbidities for people living with HIV: Perspectives and experiences of patients and healthcare providers.

机构信息

Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Department of Biomedical Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.

出版信息

Glob Public Health. 2023 Jan;18(1):2185798. doi: 10.1080/17441692.2023.2185798.

Abstract

As the cohort of People Living with HIV (PLHIV) ages, so does the spectrum and burden of non-AIDS define HIV-associated conditions (NARC). PLHIV are likely to need different and increased healthcare services. It requires health systems to adapt to this disease trend and conform to a chronic care model, which respects the distinct needs of the ageing population. In this article, we explore the lived experiences of PLHIV and their healthcare providers in managing the challenges of dealing with NARC in Arba Minch, Southern Ethiopia. This study utilises interpretative substantive methods, encompassing qualitative interviews and Focus Group Discussions. The Normalisation Practice Theory (NPT) guided the semi-structured questions concerning routine screenings and current models of HIV care for ageing individuals. The main structural challenges in providing adequate geriatric care included: (i) the lack of awareness of the risk of NARCs; (ii) the absence of blended care; (iii) an HIV-centred approach exclusive of multidisciplinary care; and (iv) financial constraints. In an era with increasing NARCs, traditional HIV care models must adapt to the emerging challenges of a 'greying' and growing population.

摘要

随着感染艾滋病毒的人群(PLHIV)年龄的增长,非艾滋病定义的艾滋病毒相关病症(NARC)的范围和负担也随之增加。PLHIV 可能需要不同的、更多的医疗保健服务。这就要求卫生系统适应这一疾病趋势,并符合慢性病护理模式,尊重老年人口的特殊需求。在本文中,我们探讨了在埃塞俄比亚南部阿尔巴明奇,PLHIV 及其医疗服务提供者在管理 NARC 挑战方面的生活体验。本研究采用解释性实质性方法,包括定性访谈和焦点小组讨论。常态实践理论(NPT)指导了有关常规筛查和针对老年人的现有艾滋病毒护理模式的半结构化问题。提供充分老年护理的主要结构挑战包括:(i)缺乏对 NARC 风险的认识;(ii)缺乏混合护理;(iii)以艾滋病毒为中心的方法,不包括多学科护理;以及(iv)财政限制。在 NARC 不断增加的时代,传统的艾滋病毒护理模式必须适应“老龄化”和不断增长的人口所带来的新挑战。

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