Dhlakama Patricia Mae, Lelaka Constance Matshidiso, Mavhandu-Mudzusi Azwihangwisi Helen
Department of Health Studies, College of Human Sciences: University of South Africa, Pretoria, Gauteng Province, South Africa.
The Discipline of Social Work, School of Human & Community Development, University of the Witwatersrand, Johannesburg, 2000, South Africa.
HIV AIDS (Auckl). 2023 Sep 28;15:583-598. doi: 10.2147/HIV.S401336. eCollection 2023.
The study explored the psychosocial profile of women who defaulted Option B+ HIV treatment at Chitungwiza Municipality clinics in Zimbabwe. Option B+ is a strategy to prevent mother-to-child transmission (PMTCT) of HIV to reduce MTCT rate to less than or equal to 5%.
An interpretive phenomenological analysis (IPA) design was used. Data were collected from 04 September to 12 October 2020 on twelve purposively selected HIV-positive breastfeeding women aged 18 to 40 years, who defaulted Option B+ HIV treatment. Unstructured individual face-to-face interviews were utilised. Data were analysed thematically using the interpretive phenomenological analysis framework for data analysis.
The study findings revealed that participants experienced the following: psychosocial and emotional challenges due to HIV positive results, shown emotional distress and suicidal tendencies which affected their mental health. Their relationship was derailed due to abuse, infidelity, partner's high-risk behaviour and to lack of support stemming from their partners and family members.
Strengthening adherence support interventions and effective counselling on HIV-positive status disclosure and male partner involvement is important for retaining women in care and for improving their quality of life. Comprehensive, integrated, and tailor-made interventions should be adopted. Couple HIV counselling and testing should be encouraged. Psychosocial and mental health should be encouraged. Furthermore, community sensitization, risk reduction behaviour, education on purpose and side effects of ART as well as the benefits of Option B+ to new enrolments should be intensified and strengthened to minimize defaulting of treatment and LTFUP. Vigorous patient tracing and visit reminders help retain women in care.
本研究探讨了在津巴布韦奇通圭扎市诊所中未坚持接受B+方案HIV治疗的女性的心理社会状况。B+方案是一种预防母婴传播(PMTCT)HIV的策略,可将母婴传播率降低至5%及以下。
采用解释性现象学分析(IPA)设计。于2020年9月4日至10月12日收集了12名年龄在18至40岁之间、有目的地选取的未坚持接受B+方案HIV治疗的HIV阳性哺乳期妇女的数据。采用非结构化的个人面对面访谈。使用解释性现象学分析框架对数据进行主题分析。
研究结果显示,参与者经历了以下情况:HIV检测呈阳性带来的心理社会和情感挑战,表现出情绪困扰和自杀倾向,这影响了她们的心理健康。她们的关系因虐待、不忠、伴侣的高危行为以及伴侣和家庭成员缺乏支持而受到破坏。
加强依从性支持干预以及就HIV阳性状况披露和男性伴侣参与进行有效的咨询,对于使女性持续接受治疗并改善她们的生活质量至关重要。应采用全面、综合且量身定制的干预措施。应鼓励夫妻进行HIV咨询和检测。应关注心理社会和心理健康。此外,应加强社区宣传、降低风险行为、关于抗逆转录病毒治疗目的和副作用以及B+方案对新登记患者益处的教育,以尽量减少治疗中断和失访。积极的患者追踪和就诊提醒有助于使女性持续接受治疗。