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在 COVID-19 大流行期间,津巴布韦男男性行为者获取艾滋病毒预防、治疗和护理服务的情况:一项阐释现象学分析研究。

Access to HIV prevention, treatment, and care services during COVID-19 by men who have sex with men in Zimbabwe, An interpretive phenomenological analysis study.

机构信息

Department of HIV Services, Populations Solutions for Health, Harare, Zimbabwe.

Department of Health Studies, University of South Africa, Pretoria, South Africa.

出版信息

PLoS One. 2023 Apr 14;18(4):e0281799. doi: 10.1371/journal.pone.0281799. eCollection 2023.


DOI:10.1371/journal.pone.0281799
PMID:37058488
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10104336/
Abstract

BACKGROUND: Key populations are disproportionately affected by the human immunodeficiency virus (HIV) but have less access to HIV prevention and treatment services. The Coronavirus disease-2019 (COVID-19) pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). Therefore, this article presents the findings describing the experiences of MSM in accessing HIV services during COVID-19 in the second largest city of Zimbabwe. METHODS: An interpretative phenomenological analysis design was applied to gain some insights regarding the lived experiences of MSM in accessing HIV prevention, treatment, and care services during COVID-19 lockdowns era in Zimbabwe. Data were collected from 14 criterion purposively selected MSM using in-depth, one-on-one interviews. Data were analysed thematically guided by the interpretative phenomenological analysis framework for data analysis. RESULTS: The findings demonstrated that during the COVID -19 lockdowns in Zimbabwe, MSM faced several barriers as they tried to access HIV services. Some of the barriers included the need for travel authorisation letters and treatment interruption. The study also found that COVID-19 and related restrictive measures had psychosocial and economic effects that encompassed loss of income, intimate partner violence and psychological effects. CONCLUSIONS: Limited access to healthcare services by MSM due to COVID-19 lockdown may negatively affect the viral suppression and fuel the spread of HIV, which may reverse the gains toward the control of HIV epidemic. To sustain the gains toward HIV epidemic control and to ensure continuity of treatment, particularly for members of key populations, it is critical that the health-care delivery system adjusts by taking service to the community through adopting a differentiated service delivery approach.

摘要

背景:关键人群受人类免疫缺陷病毒(HIV)的影响不成比例,但获得 HIV 预防和治疗服务的机会较少。冠状病毒病-2019(COVID-19)大流行正在加剧弱势人群中的健康不平等,包括男男性行为者(MSM)。因此,本文介绍了在津巴布韦第二大城市,描述 MSM 在 COVID-19 期间获得 HIV 服务的经验的研究结果。

方法:应用解释现象学分析设计,深入了解 MSM 在 COVID-19 封锁期间获得 HIV 预防、治疗和护理服务的生活体验。通过深入的一对一访谈,从 14 名符合标准的 MSM 中收集数据。数据分析采用解释现象学分析框架,进行主题分析。

结果:研究结果表明,在津巴布韦 COVID-19 封锁期间,MSM 在尝试获得 HIV 服务时面临多种障碍。一些障碍包括需要旅行授权信和治疗中断。研究还发现,COVID-19 及其相关限制措施对 MSM 产生了心理和经济影响,包括收入损失、亲密伴侣暴力和心理影响。

结论:由于 COVID-19 封锁,MSM 获得医疗保健服务的机会有限,可能会对病毒抑制产生负面影响,并助长 HIV 的传播,这可能会逆转控制 HIV 流行的成果。为了维持控制 HIV 流行的成果,并确保关键人群的治疗连续性,至关重要的是医疗保健提供系统通过采用差异化的服务提供方法,将服务推向社区进行调整。

相似文献

[1]
Access to HIV prevention, treatment, and care services during COVID-19 by men who have sex with men in Zimbabwe, An interpretive phenomenological analysis study.

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[7]
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引用本文的文献

[1]
Barriers and facilitators of HIV treatment services among men who have sex with men during COVID-19 lockdown.

South Afr J HIV Med. 2025-4-24

[2]
"I am still human and worth a life:" a qualitative study of the impacts of a community based, peer-led, treatment support model for young adults living with HIV in Zimbabwe.

Front Public Health. 2024

本文引用的文献

[1]
Protecting HIV service delivery for key populations in southern Africa in the context of the COVID-19 pandemic.

IJID Reg. 2022-6

[2]
Targeting those left behind in Zimbabwe's HIV response: A call for decriminalisation of key populations to rapidly achieve 95-95-95 targets.

S Afr Med J. 2021-4-30

[3]
The lived experiences of men who have sex with men when accessing HIV care services in Zimbabwe.

Health SA. 2021-4-22

[4]
The impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China.

J Int AIDS Soc. 2021-4

[5]
Experiences of Intimate Partner Violence during Lockdown and the COVID-19 Pandemic.

J Fam Violence. 2022

[6]
Low Psychological Well-being in Men Who Have Sex with Men (MSM) During the Shelter-in-Place Orders to Prevent the COVID-19 Spread: Results from a Nationwide Study.

Sex Res Social Policy. 2022

[7]
Perceived Interruptions to HIV Prevention and Treatment Services Associated With COVID-19 for Gay, Bisexual, and Other Men Who Have Sex With Men in 20 Countries.

J Acquir Immune Defic Syndr. 2021-5-1

[8]
The interplay between HIV and COVID-19: summary of the data and responses to date.

Curr Opin HIV AIDS. 2021-1

[9]
COVID-19, HIV and key populations: cross-cutting issues and the need for population-specific responses.

J Int AIDS Soc. 2020-10

[10]
Maintaining robust HIV and tuberculosis services in the COVID-19 era: A public health dilemma in Zimbabwe.

Int J Infect Dis. 2020-9-24

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