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南非基层医疗服务提供者对六个月抗逆转录病毒疗法(ART)配药的看法:观点与偏好的横断面调查

Primary healthcare providers' perspectives on six-month dispensing of antiretroviral therapy (ART) in South Africa: cross-sectional survey of views and preferences.

作者信息

Ntjikelane Vinolia, Huber Amy, Morgan Allison, Pascoe Sophie, Manganye Musa, Malala Lufuno, Rosen Sydney

机构信息

Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Department of Global Health, Boston University School of Public Health, Boston, MA, USA.

出版信息

Glob Health Action. 2025 Dec;18(1):2484111. doi: 10.1080/16549716.2025.2484111. Epub 2025 Apr 9.


DOI:10.1080/16549716.2025.2484111
PMID:40200851
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11983522/
Abstract

BACKGROUND: Many African countries have increased the dispensing duration of antiretroviral therapy (ART) from 3 months to 6 months for established HIV treatment clients. OBJECTIVE: To assess South African healthcare providers' views on the benefits and challenges of the current maximum ART dispensing duration (3-month, 3MMD) and of potential 6-month dispensing (6MMD) to help inform South Africa about whether to move from 3MMD to 6MMD. METHODS: We conducted a cross-sectional survey of healthcare providers at 24 primary healthcare clinics in South Africa from May to September 2024. We used descriptive analysis for quantitative data and analysed open-ended responses using conventional qualitative content analysis methods. RESULTS: A total of 182 providers were enrolled from four provinces (median age 44, 88% female). Most (>70%) respondents said that 3MMD offered multiple benefits for providers and patients, and most (64%) also said there were no challenges in implementing 3MMD. More than 80% of respondents across all cadres reported that they would be comfortable dispensing 6 months of ART at a time, believing that it would reduce the facility overcrowding, lighten staff workloads, and be advantageous to clients by decreasing their visit burden and travel costs. Two thirds (63%) of participating nurses, who provide the largest share of direct ART care, were also in favour of resuming 12-month scripting for ART; the remaining 37% expressed concerns about decreases in treatment adherence and clinical monitoring of clients. CONCLUSION: Most healthcare providers at primary healthcare clinics in South Africa are in favour of allowing 6-month dispensing and 12-month prescriptions as options for established ART clients.

摘要

背景:许多非洲国家已将确诊感染艾滋病毒的患者接受抗逆转录病毒疗法(ART)的配药时长从3个月延长至6个月。 目的:评估南非医疗服务提供者对于当前ART最长配药时长(3个月,即3MMD)以及潜在的6个月配药时长(6MMD)的益处和挑战的看法,以帮助南非了解是否应从3MMD转变为6MMD。 方法:2024年5月至9月,我们对南非24家初级医疗诊所的医疗服务提供者进行了横断面调查。我们对定量数据进行描述性分析,并使用传统定性内容分析方法分析开放式回答。 结果:共从四个省份招募了182名医疗服务提供者(中位年龄44岁,88%为女性)。大多数(>70%)受访者表示,3MMD对医疗服务提供者和患者有多重益处,且大多数(64%)受访者还表示实施3MMD没有挑战。所有干部类别的受访者中,超过80%报告称他们愿意一次配给6个月的ART药物,认为这将减少机构内的拥挤情况,减轻工作人员的工作量,并通过减轻患者的就诊负担和交通成本而对患者有利。提供大部分直接ART护理的参与调查护士中有三分之二(63%)也赞成恢复为ART开具12个月的药方;其余37%的护士对患者治疗依从性下降和临床监测表示担忧。 结论:南非初级医疗诊所的大多数医疗服务提供者赞成允许为确诊感染艾滋病毒的患者选择6个月配药和12个月处方。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/63deb37468dd/ZGHA_A_2484111_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/a3033417bd80/ZGHA_A_2484111_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/5c91a917db4e/ZGHA_A_2484111_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/63deb37468dd/ZGHA_A_2484111_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/a3033417bd80/ZGHA_A_2484111_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/5c91a917db4e/ZGHA_A_2484111_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf11/11983522/63deb37468dd/ZGHA_A_2484111_F0003_OC.jpg

相似文献

[1]
Primary healthcare providers' perspectives on six-month dispensing of antiretroviral therapy (ART) in South Africa: cross-sectional survey of views and preferences.

Glob Health Action. 2025-12

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Uptake and associated factors of six multi-month scripting/appointment spacing differentiated service delivery model of care among stable clients on antiretroviral therapy in Southern Ethiopia.

PLoS One. 2024

[2]
Healthcare worker perspectives on adaptations to differentiated anti-retroviral therapy delivery during COVID-19 in South Africa: A qualitative inquiry.

PLOS Glob Public Health. 2024-8-9

[3]
Clinical outcomes after extended 12-month antiretroviral therapy prescriptions in a community-based differentiated HIV service delivery programme in South Africa: a retrospective cohort study.

J Int AIDS Soc. 2023-9

[4]
The SENTINEL study of differentiated service delivery models for HIV treatment in Malawi, South Africa, and Zambia: research protocol for a prospective cohort study.

BMC Health Serv Res. 2023-8-23

[5]
Implementing six multi-month dispensing of antiretroviral therapy in Ethiopia: perspectives of clients and healthcare workers.

BMC Health Serv Res. 2023-5-31

[6]
Evaluation of HIV treatment outcomes with reduced frequency of clinical encounters and antiretroviral treatment refills: A systematic review and meta-analysis.

PLoS Med. 2022-3

[7]
Implementation of South Africa's Central Chronic Medicine Dispensing and Distribution Program for HIV Treatment: A Qualitative Evaluation.

AIDS Behav. 2022-8

[8]
Multimonth dispensing of up to 6 months of antiretroviral therapy in Malawi and Zambia (INTERVAL): a cluster-randomised, non-blinded, non-inferiority trial.

Lancet Glob Health. 2021-5

[9]
Economic evaluation of differentiated service delivery models for HIV treatment in Lesotho: costs to providers and patients.

J Int AIDS Soc. 2021-4

[10]
Twenty-four-month outcomes from a cluster-randomized controlled trial of extending antiretroviral therapy refills in ART adherence clubs.

J Int AIDS Soc. 2020-12

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