Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Research Triangle Institute (RTI) International, Research Triangle Park, NC, USA.
J Int Assoc Provid AIDS Care. 2024 Jan-Dec;23:23259582241269919. doi: 10.1177/23259582241269919.
Early initiation of antiretroviral therapy improves human immunodeficiency virus (HIV) outcomes. However, achieving earlier treatment initiation is challenging for many reasons including provider awareness and clinic barriers; this study sought to understand perceptions of an early initiation program.
We interviewed 10 providers from 3 HIV clinics in North Carolina (October-November 2020). We asked providers about overall perceptions of early initiation and the pilot program. We developed narrative summaries to understand individual contexts and conducted thematic analysis using NVivo.
Providers believed earlier initiation would signal an "extra sense of urgency" about the importance of antiretroviral therapy-a message not currently reflected in standard of care. Safety was a consistent concern. Cited implementation barriers included transportation assistance, medication sustainability, and guidance to address increased staff time and appointment availability.
Our qualitative findings highlight the need for training on the safety of early initiation and addressing staffing needs to accommodate quicker appointments.
早期开始抗逆转录病毒疗法可改善人类免疫缺陷病毒（HIV）的预后。然而，由于包括提供者意识和诊所障碍在内的多种原因，实现早期治疗的启动具有挑战性；本研究旨在了解对早期启动计划的看法。
我们采访了北卡罗来纳州的 3 家 HIV 诊所的 10 名提供者（2020 年 10 月至 11 月）。我们询问了提供者对早期启动和试点计划的总体看法。我们编写了叙述性总结，以了解个人背景，并使用 NVivo 进行了主题分析。
提供者认为早期启动将对抗逆转录病毒治疗的重要性发出“额外的紧迫感”信号，而这一信息目前并未反映在标准护理中。安全性是一个持续关注的问题。实施障碍包括交通援助、药物可持续性以及解决增加的工作人员时间和预约可用性的指导。
我们的定性研究结果强调了需要培训早期启动的安全性，并满足工作人员需求以适应更快捷的预约。
