School of Nursing, Vanderbilt University, Nashville, U.S.A.
Department of Social and Behavioural Sciences, Temple University, Philadelphia, U.S.A.
AIDS Care. 2024 Jan;36(1):130-138. doi: 10.1080/09540121.2023.2233498. Epub 2023 Aug 3.
Women living in the South have the second highest rate of HIV and the lowest rate of viral suppression among women in all regions in the United States (U.S.). Viral suppression is achieved by successfully linking women to HIV care and supporting adherence to antiretroviral therapy (ART). We aimed to qualitatively explore perceived barriers and facilitators to HIV care engagement and ART adherence among women living with HIV in the South. Participants (N = 40) were recruited across a broad geographic area of the South, assisted by a location-specific Community/Clinician Advisory Board (CCAB). Qualitative research methods were used to generate in-depth descriptions of women's experiences in accessing HIV care and adhering to ART. Intrapersonal qualities expressed through resilience and self-efficacy were amongst the most prominent themes for both engagement in care and adherence to medications. Structural barriers such as transportation and distance to care continued to be a barrier to engagement, while medication delivery facilitated adherence. Conclusion: Our findings highlight the complexity and interrelated nature of factors impacting care and adherence. Multilevel interventions that incorporate structural factors in addition to individual-level behavioral change are needed to facilitate engagement in care and adherence to ART.
居住在美国南部的女性，其 HIV 感染率在全美所有地区中排名第二，病毒抑制率却是最低的。病毒抑制是通过成功将女性与 HIV 护理联系起来，并支持其接受抗逆转录病毒治疗（ART）来实现的。我们旨在定性探讨居住在南部的 HIV 感染女性参与 HIV 护理和坚持接受 ART 治疗的障碍和促进因素。研究参与者（n=40）是在南部广泛的地理区域内招募的，由特定地点的社区/临床顾问委员会（CCAB）协助完成。采用定性研究方法深入描述了女性在获得 HIV 护理和坚持接受 ART 治疗方面的经历。在参与护理和坚持用药方面，通过韧性和自我效能表达的个人内在素质是最突出的主题之一。交通和护理距离等结构性障碍仍然是参与的障碍，而药物输送则有助于坚持用药。结论：我们的研究结果突出了影响护理和坚持用药的因素的复杂性和相互关系。需要采取多层次的干预措施，将结构性因素与个人层面的行为改变结合起来，以促进参与护理和坚持接受 ART 治疗。
