Rujumba Joseph, King Rachel L, Namale-Matovu Joyce, Wavamunno Priscilla, Amone Alexander, Gabagaya Grace, Rukundo Gordon, Fowler Mary Glenn, Homsy Jaco, Seeley Janet, Musoke Philippa
Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, United States of America.
PLOS Glob Public Health. 2023 Nov 7;3(11):e0001326. doi: 10.1371/journal.pgph.0001326. eCollection 2023.
The Friends for Life Circles (FLC) was a parallel randomized controlled trial testing the efficacy of a group peer support intervention to support long-term adherence to Option B+ in Kampala and Mityana districts in Uganda. We explored FLC participants' experiences and perceptions of the intervention on adherence to Option B+ for PMTCT and potential implications for strengthening the PMTCT program. We collected data from six focus group discussions with lactating women enrolled in the FLC intervention, and from 14 key informant interviews with health workers, district and national level stakeholders, as well as male partners of FLC participants. Data were analysed using a content thematic approach in a continuous and iterative process. Women described the FLC intervention as acceptable and beneficial in enhancing their understanding of HIV and the need for ART. The FLC helped women, especially those newly diagnosed with HIV infection to come to terms with their diagnosis and overcome the fear of death linked to testing HIV positive, and provided opportunities to enhance ART initiation, resumption and adherence. The FLC provided safe spaces for women, to learn about ART, and to receive support from peers including adherence reminders through home visits and 'coded' reminder messages. Receiving ART from support groups protected members from stigma and long lines at health facilities. Fear of stigma, health system challenges, the high cost of caring for animals and lack of money to save in groups were key challenges noted. The FLC support groups were crucial in providing needed support for women to initiate, resume and adhere to lifelong ART for Option B+. It is important that women who test HIV positive and start ART for life receive psychosocial support from peers and health workers to improve chances of preventing HIV transmission from mothers to children.
“终身之友圈子”（FLC）是一项平行随机对照试验，旨在测试一种小组同伴支持干预措施在乌干达坎帕拉和米蒂亚纳地区支持长期坚持“B+方案”的效果。我们探讨了FLC参与者对该干预措施在坚持预防母婴传播（PMTCT）的“B+方案”方面的经历和看法，以及对加强PMTCT项目的潜在影响。我们从与参与FLC干预措施的哺乳期妇女进行的六次焦点小组讨论中收集了数据，还从对卫生工作者、地区和国家层面的利益相关者以及FLC参与者的男性伴侣进行的14次关键信息访谈中收集了数据。采用内容主题分析法在一个连续且迭代的过程中对数据进行了分析。妇女们将FLC干预措施描述为可接受且有益的，有助于增强她们对艾滋病毒的理解以及对接受抗逆转录病毒治疗（ART）必要性的认识。FLC帮助妇女，尤其是那些新诊断出感染艾滋病毒的妇女接受诊断，并克服与检测出艾滋病毒呈阳性相关的死亡恐惧，还提供了增加开始、恢复和坚持接受ART的机会。FLC为妇女提供了安全的空间，让她们了解ART，并从同伴那里获得支持，包括通过家访和“编码”提醒信息进行依从性提醒。从支持小组获得ART使成员免受耻辱，并避免了在医疗机构排长队。对耻辱的恐惧、卫生系统的挑战、照顾动物的高昂成本以及在小组中缺乏储蓄资金是所指出的关键挑战。FLC支持小组对于为妇女启动、恢复并坚持终身接受“B+方案”的ART提供所需支持至关重要。对于检测出艾滋病毒呈阳性并开始终身接受ART的妇女来说，获得同伴和卫生工作者的心理社会支持以提高预防艾滋病毒母婴传播的几率非常重要。
