Sithole Nsika, Nkosi Busisiwe, Seeley Janet, Barnabas Ruanne V, Siedner Mark J, Moshabela Mosa
Africa Health Research Institute, KwaZulu-Natal, South Africa.
Department of Social Work, University of Toledo, Toledo, OH, USA.
AIDS Care. 2025 May;37(5):864-871. doi: 10.1080/09540121.2025.2479044. Epub 2025 Mar 18.
In South Africa, people living with HIV (PWH) often relocate for work and family obligations, which creates unique challenges for continuous HIV care. We explored the experiences of mobile individuals living with HIV navigating clinic transfers without formal letters. A qualitative study was conducted with PWH on antiretroviral therapy (ART) from two clinics in KwaZulu-Natal. Participants, who had not disclosed their HIV treatment history at registration, were interviewed in-depth between March and October 2023. Content and thematic analyses, informed by Andersen's behavioral model and self-management domains, were used. This study presents two case studies of individuals who faced challenges with accessing ART after relocating to new areas: a 37-year-old female worker and a 47-year-old male construction worker. Both faced difficulties accessing ART after relocation. When they presented at new clinics, they were told they could not access care without transfer letters. Unable to return to previous clinics, they sought treatment at a third clinic as treatment-naive, changing their names to avoid detection. To cover ART gaps, they also purchased or borrowed ART from others. These individuals developed strategies to overcome barriers. Educating clinic staff on the challenges faced by migrants could help improve transfers.
在南非，感染艾滋病毒的人（PWH）常常因工作和家庭责任而搬迁，这给持续的艾滋病毒护理带来了独特挑战。我们探讨了感染艾滋病毒的流动人员在没有正式转诊信的情况下转诊诊所的经历。对夸祖鲁 - 纳塔尔省两家诊所接受抗逆转录病毒疗法（ART）的艾滋病毒感染者进行了一项定性研究。2023年3月至10月期间，对在登记时未透露其艾滋病毒治疗史的参与者进行了深入访谈。采用了基于安徒生行为模型和自我管理领域的内容分析和主题分析方法。本研究介绍了两名在搬到新地区后在获取抗逆转录病毒疗法方面面临挑战的个人案例：一名37岁的女工和一名47岁的男性建筑工人。两人在搬迁后获取抗逆转录病毒疗法都遇到了困难。当他们前往新诊所时，被告知没有转诊信就无法获得治疗。由于无法返回之前的诊所，他们作为初治患者在第三家诊所寻求治疗，并更改了名字以避免被发现。为了弥补抗逆转录病毒疗法的缺口，他们还从他人那里购买或借用了抗逆转录病毒药物。这些人制定了克服障碍的策略。让诊所工作人员了解移民面临的挑战有助于改善转诊情况。
