Pact Tanzania, Dar es Salaam, Tanzania.
National Institute for Medical Research (NIMR), Dar es Salaam, Tanzania.
Front Public Health. 2023 Sep 15;11:1215219. doi: 10.3389/fpubh.2023.1215219. eCollection 2023.
Support groups for people living with HIV (PLHIV) are essential for increasing adherence, retention, addressing their psychosocial needs and improving patient literacy. However, factors that influence participation of caregivers living with HIV (LHIV) in these groups are scarcely documented, particularly for those caring for orphans and vulnerable children (OVC).
This study used baseline data collected between 1st October 2021 and 30th September 2022 from the PEPFAR/USAID-funded Adolescents and Children HIV Incidence Reduction, Empowerment and Virus Elimination (ACHIEVE) project in Tanzania to investigate factors that affect participation of caregivers LHIV in support groups for PLHIV. A total of 74,249 HIV-positive OVC caregivers who were already receiving antiretroviral therapy (ART) and had a confirmed care and treatment centre identification number were included in the analysis. Factors affecting group participation were identified through multilevel analysis using multivariable mixed-effects logistic regression.
Results showed that 84.2% of the caregivers were participants in the support groups for PLHIV. Their mean age was 36 years, and the majority (82.1%) were female. Multivariable analysis revealed that participation in the groups was more likely among caregivers living in urban areas (aOR = 1.39 [1.24, 1.55]), with primary education (aOR = 1.17 [1.07, 1.28]), and without disabilities (aOR = 0.62 [0.47, 0.82]). However, participation was less likely among widowed (aOR = 0.91 [0.84, 0.999]), single or unmarried (aOR = 0.86 [0.78, 0.95]), and those with secondary education or higher levels than never attended (aOR = 0.69 [0.60, 0.80]), moderate hunger (aOR = 0.86 [0.79, 0.93]), and those aged 30 years or older (< 0.001).
A sizeable proportion (15.8%) of the caregivers were not in support groups for PLHIV, ranging from 12.3% among those in households with severe hunger to 29.7% among disabled ones. The study highlights the need for tailored interventions to increase participation in support groups for PLHIV, particularly for caregivers who are disabled, live in rural areas, are older, widowed, and/or unmarried, and those in poor households.
为了提高依从性、保留率、满足他们的心理社会需求并提高患者的读写能力，支持生活在 HIV 中的人（PLHIV）的支持小组是必不可少的。然而，影响照顾生活在 HIV 中的人的参与的因素（LHIV）在这些小组中很少有记录，特别是对于那些照顾孤儿和弱势儿童（OVC）的人。
本研究使用了 2021 年 10 月 1 日至 2022 年 9 月 30 日期间，由美国国际开发署（USAID）资助的青少年和儿童 HIV 发病率降低、赋权和病毒消除（ACHIEVE）项目从坦桑尼亚收集的基线数据，调查了影响 HIV 阳性 OVC 照顾者参与 PLHIV 支持小组的因素。共有 74249 名已经接受抗逆转录病毒治疗（ART）并已确认关怀和治疗中心识别号码的 HIV 阳性 OVC 照顾者纳入分析。通过多变量混合效应逻辑回归对多水平分析中影响组参与的因素进行了识别。
结果显示，84.2%的照顾者参加了 PLHIV 支持小组。他们的平均年龄为 36 岁，大多数（82.1%）为女性。多变量分析显示，居住在城市地区（aOR = 1.39 [1.24, 1.55]）、接受过小学教育（aOR = 1.17 [1.07, 1.28]）和没有残疾的照顾者更有可能参加小组（aOR = 0.62 [0.47, 0.82]）。然而，丧偶（aOR = 0.91 [0.84, 0.999]）、单身或未婚（aOR = 0.86 [0.78, 0.95]）、接受过中学或更高教育的人（aOR = 0.69 [0.60, 0.80]）、中度饥饿（aOR = 0.86 [0.79, 0.93]）和 30 岁或以上的人（<0.001）的参与率较低。
相当一部分（15.8%）的照顾者没有参加 PLHIV 支持小组，其中在严重饥饿的家庭中这一比例为 12.3%，在残疾的家庭中为 29.7%。该研究强调需要采取有针对性的干预措施，以增加参与 PLHIV 支持小组的人数，特别是那些残疾、居住在农村地区、年龄较大、丧偶和/或未婚以及生活在贫困家庭中的人。
