Larsson Markus, N'Diaye Arielle, Lusimbo Richard, Agardh Anette
Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
Uganda Key Population Consortium, Kampala, Uganda.
PLOS Glob Public Health. 2023 Jan 19;3(1):e0001475. doi: 10.1371/journal.pgph.0001475. eCollection 2023.
In Uganda, due to the criminalization of same-sex sexual practices, men who have sex with men (MSM) experience barriers to accessing HIV care. To retain patients within the HIV Care Continuum, some health interventions have used patient navigators as an ancillary support service. To understand the potential care benefits of using patient navigators for marginalized populations experiencing challenges to HIV care and treatment access in a Ugandan context, this qualitative study explored the experiences of newly diagnosed MSM using patient navigators for ARV retention in care in Kampala. Additionally, to gain insight into the feasibility of patient navigator interventions, this study also aimed to understand the perspectives and experiences of patient navigators working with HIV positive MSM. Individual in-depth, semi structured interviews were conducted with 24 HIV positive MSM and four patient navigators that were part of a patient navigator pilot program from January 2019 -December 2020. Analysis was done using manifest and latent qualitative content analysis. Results showed that HIV positive MSM in Uganda experienced a variety of social, emotional, and financial challenges that placed them at risk for dropping off the HIV Care Continuum. Patient navigators provided HIV positive MSM with the skills, support, and resources necessary to overcome these challenges. Based on study results, we conclude that within the patient navigator pilot program, patient navigators improved MSM participants' quality of life by helping them to achieve the HIV Care Continuum stages: diagnosis, linked to care, receiving HIV treatment, and retention in care. Study results suggest future research is needed on the psychosocial support needs of patient navigators, how the support needs of MSM change throughout their lifetime on the HIV Care Continuum, and how potential benefits of patient navigators may differ in rural Ugandan contexts.
在乌干达，由于同性性行为被定罪，男男性行为者（MSM）在获得艾滋病毒护理方面面临障碍。为了使患者留在艾滋病毒护理连续统一体中，一些健康干预措施使用患者导航员作为辅助支持服务。为了了解在乌干达背景下，对于在获得艾滋病毒护理和治疗方面面临挑战的边缘化人群使用患者导航员可能带来的护理益处，这项定性研究探讨了新诊断的男男性行为者使用患者导航员在坎帕拉接受抗逆转录病毒治疗并留在护理体系中的经历。此外，为了深入了解患者导航员干预措施的可行性，本研究还旨在了解与艾滋病毒呈阳性的男男性行为者合作的患者导航员的观点和经历。2019年1月至2020年12月期间，对24名艾滋病毒呈阳性的男男性行为者和4名患者导航员进行了个人深入的半结构化访谈，这些人是患者导航员试点项目的一部分。使用显性和隐性定性内容分析法进行分析。结果表明，乌干达艾滋病毒呈阳性的男男性行为者经历了各种社会、情感和经济挑战，这使他们有脱离艾滋病毒护理连续统一体的风险。患者导航员为艾滋病毒呈阳性的男男性行为者提供了克服这些挑战所需的技能、支持和资源。根据研究结果，我们得出结论，在患者导航员试点项目中，患者导航员通过帮助男男性行为者参与者实现艾滋病毒护理连续统一体的各个阶段：诊断、与护理机构建立联系、接受艾滋病毒治疗以及留在护理体系中，提高了他们的生活质量。研究结果表明，未来需要对患者导航员的心理社会支持需求、男男性行为者在其艾滋病毒护理连续统一体一生中的支持需求如何变化，以及患者导航员的潜在益处在乌干达农村地区可能有何不同进行研究。
