Brown Tony, Addo Prince Nii Ossah, Brown Monique J, Li Xiaoming, Adeagbo Oluwafemi
Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
J Int Assoc Provid AIDS Care. 2025 Jan-Dec;24:23259582251343669. doi: 10.1177/23259582251343669. Epub 2025 May 27.
BackgroundHIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers' willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers' perceptions of HIV testing and treatment uptake among MSM, and providers' willingness to use mHealth technology to address barriers to HIV testing and treatment in SC.MethodsBetween August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on their experience (2-11 years of service) providing HIV-related services to MSM in peri-urban ( = 7) and rural ( = 3) SC. The interviews were audio recorded, lasted 40-70 min, and were transcribed verbatim. The interview transcripts were analyzed inductively.ResultsFive themes emerged from the analysis: (a) challenges to HIV testing services; (b) concerns about HIV knowledge and status in the MSM community; (c) mixed feelings about HIV self-testing; (d) providers' perception of HIV treatment uptake and retention; and (e) potential of mHealth technology for the delivery of HIV care. Overall, participants reported limited resources, homophobia, medical mistrust, distance, medical costs, and HIV-related stigma as major barriers to HIV testing and treatment uptake in their localities (especially in rural areas). Particularly, they reported that MSM experience significant stigma associated with their sexual orientation and HIV.ConclusionsGiven barriers to care such as stigma and lack of access to care still impede MSM from receiving appropriate HIV services, mHealth-connected approaches could potentially address the barriers to HIV testing and care among MSM and improve their health outcomes. This is key to ending the HIV epidemic in SC and the United States by 2030.
背景
在南卡罗来纳州(SC),艾滋病毒仍然是一个重要的公共卫生问题。然而,目前SC缺乏对医疗服务提供者使用移动健康技术来消除艾滋病毒护理和预防策略中持续存在的障碍的意愿的研究,特别是在男男性行为者(MSM)中。因此,我们探讨了艾滋病毒护理提供者对MSM中艾滋病毒检测和治疗接受情况的看法,以及提供者使用移动健康技术来消除SC艾滋病毒检测和治疗障碍的意愿。
方法
在2021年8月至12月期间,我们对10名艾滋病毒护理提供者进行了半结构化虚拟访谈,这些提供者是根据他们在城郊(n = 7)和农村(n = 3)SC为MSM提供艾滋病毒相关服务的经验(服务2 - 11年)有目的地招募的。访谈进行了录音,持续40 - 70分钟,并逐字转录。对访谈记录进行归纳分析。
结果
(a)艾滋病毒检测服务面临的挑战;(b)对MSM社区中艾滋病毒知识和状况的担忧;(c)对艾滋病毒自我检测的复杂感受;(d)提供者对艾滋病毒治疗接受情况和留存率的看法;(e)移动健康技术在提供艾滋病毒护理方面的潜力。总体而言,参与者报告说资源有限、恐同、医疗不信任、距离、医疗费用以及与艾滋病毒相关的耻辱感是当地(特别是农村地区)艾滋病毒检测和治疗接受的主要障碍。特别是,他们报告说MSM因其性取向和艾滋病毒而经历了重大耻辱。
结论
鉴于耻辱感和缺乏医疗服务等护理障碍仍然阻碍MSM获得适当的艾滋病毒服务,与移动健康相关的方法可能潜在地消除MSM中艾滋病毒检测和护理的障碍,并改善他们的健康结果。这是到2030年在SC和美国结束艾滋病毒流行的关键。