调查尼日利亚高原州 HIV 阳性妇女使用抗逆转录病毒疗法的障碍和促进因素。
Investigating the Barriers and Facilitators to Using Antiretroviral Therapy among Women Living with HIV in Plateau State, Nigeria.
机构信息
APIN Public Health Initiatives Jos, Jos 930253, Plateau, Nigeria.
Department of Health Policy & Management, Rollins School of Public Health United States of America, Emory University, Atlanta, GA 30322, USA.
出版信息
Int J Environ Res Public Health. 2024 Apr 26;21(5):546. doi: 10.3390/ijerph21050546.
BACKGROUND
Women and girls account for more than 50% of the global HIV population. In Nigeria, the proportion of women living with HIV on long-term antiretroviral therapy (ART) has been on the rise. Despite this, little research exists on their experiences regarding antiretroviral therapy use, especially for women living with HIV (WLHIV) in Plateau State, Nigeria. This study investigates the barriers and facilitators influencing antiretroviral therapy use among women living with HIV.
METHODS
This study employed a qualitative research design, using focus groups, and included women (female sex workers, pregnant and non-pregnant women living with HIV) and the male partners of serodiscordant couples. Eligibility criteria were being 18 years of age or older, on antiretroviral therapy for more than one year/on pre-exposure prophylaxis (PrEP) for more than one month, and speaking English, Hausa, or both. Data coding utilized both inductive and deductive approaches, and standard content analysis was applied to develop emerging themes.
RESULTS
Of the 106 participants, 88 were women living with HIV, and 18 were men in serodiscordant couples. The first facilitator shared by the participants was feeling healthier and stronger due to the antiretroviral therapy, which was also expressed by the male participants on PrEP as feeling good while taking the drug. Additional facilitators shared by the participants included weight gain and having a more positive outlook on life. Participants also disproportionately described barriers to using antiretroviral therapy, including experiences with emotional challenges, physical discomfort, and side effects of ART. Such barriers were linked to feelings of past regret, frustration, and disappointment.
CONCLUSION
This study underscores the significance of maintaining a positive perspective on ART use, demonstrated by the connection between a positive outlook and weight gain, and highlights the hurdles that Plateau State's women living with HIV face in adhering to antiretroviral therapy. Policymakers and healthcare providers can utilize these findings to formulate targeted strategies aimed at minimizing identified barriers and enhancing antiretroviral therapy utilization among this population via peer- support groups, economic empowerment, and psychosocial support.
背景
女性和女童占全球 HIV 感染者的 50%以上。在尼日利亚，长期接受抗逆转录病毒疗法（ART）的女性 HIV 感染者的比例一直在上升。尽管如此，针对尼日利亚高原州 HIV 感染者（WLHIV）使用抗逆转录病毒疗法的经验研究却很少。本研究旨在探讨影响 HIV 感染者使用抗逆转录病毒疗法的障碍和促进因素。
方法
本研究采用定性研究设计，使用焦点小组，纳入了女性（性工作者、妊娠和非妊娠 HIV 感染者）和血清不一致夫妇的男性伴侣。入选标准为年龄在 18 岁或以上，接受抗逆转录病毒治疗一年或以上/接受暴露前预防（PrEP）一个月或以上，且能讲英语、豪萨语或两者皆可。数据编码采用归纳法和演绎法，应用标准内容分析法开发新兴主题。
结果
在 106 名参与者中，88 名为 HIV 感染者，18 名为血清不一致夫妇的男性伴侣。参与者共同分享的第一个促进因素是由于抗逆转录病毒治疗而感到更健康、更强壮，接受 PrEP 的男性伴侣也表示服用该药物时感觉良好。参与者还分享了其他促进因素，包括体重增加和对生活更积极的看法。参与者还描述了使用抗逆转录病毒疗法的障碍，包括情绪挑战、身体不适和 ART 的副作用。这些障碍与过去的遗憾、沮丧和失望感有关。
结论
本研究强调了保持对 ART 使用的积极态度的重要性，这体现在积极的态度与体重增加之间的联系，突出了高原州 HIV 感染者在坚持抗逆转录病毒治疗方面所面临的挑战。政策制定者和医疗保健提供者可以利用这些发现，制定有针对性的策略，通过同伴支持小组、经济赋权和心理社会支持，最大限度地减少确定的障碍，并提高该人群对抗逆转录病毒疗法的利用率。
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