豪登省年轻女性暴露前预防措施使用中的医疗系统障碍及策略：注册护士的观点
Healthcare systems barriers and strategies for pre-exposure prophylaxis utilization amongst young females in Gauteng province: Registered nurse's perspectives.
作者信息
Mudau Doreen Onkarabile, Mulaudzi Fhumulani Mavis, Sepeng Nombulelo Veronica, Anokwuru Rafiat
机构信息
Department of Nursing, University of Pretoria, Pretoria, South Africa.
出版信息
PLoS One. 2025 Jun 12;20(6):e0294182. doi: 10.1371/journal.pone.0294182. eCollection 2025.
BACKGROUND
Healthcare system present several barriers impacting on Pre-Exposure Prophylaxis (PrEP) utilization amongst young females. To overcome these barriers, there are strategies that could be employed to improve PrEP performance. Within healthcare system, registered nurses play critical role on PrEP utilization, however their perceptions on barriers and strategies have not been explored and described in this setting. Therefore, this paper aimed at exploring, describing and contextualizing registered nurse's perceptions on health systems barriers and strategies regarding PrEP utilization amongst young females.
METHODS
Qualitative, explorative, descriptive and contextual method was used to explore and describing registered nurse's perceptions on healthcare systems barriers and strategies regarding PrEP utilization. Purposively sampled participants for focus group discussions and data was analysed using reflexive thematic analysis.
RESULTS
Barriers and strategies regarding PrEP utilization were reported as themes which emerged with eight sub-themes. Which included; healthcare system structure, healthcare providers, health promotion and medication barriers and strategies. Healthcare system structural barriers included limited PrEP access, healthcare workers related comprised training, competency and staffing while health promotion included poor awareness, inaccurate PrEP information, HIV-ART related stigma. Pill related barriers were side effects, contraindication and monitoring burden crucial to be addressed to enhance PrEP usage. Moreover, strategies such as increased access, PrEP integration to existing HIV, FP services, Department of Education and training of nurses on PrEP would assist to overcome these barriers. Proactively managing side-effects, increased awareness, using media platforms to disseminate information, quality counselling and three-monthly injectable PrEP for the success of desired utilization amongst young females.
CONCLUSION
Findings reported healthcare system structure, healthcare providers, health promotion and medication barriers and strategies affecting utilization of PrEP voiced by registered nurses within focus group discussions.
背景
医疗保健系统存在若干障碍，影响着年轻女性对暴露前预防（PrEP）的使用。为克服这些障碍，可采用一些策略来提高PrEP的使用效果。在医疗保健系统中，注册护士在PrEP的使用方面发挥着关键作用，然而在这种背景下，尚未对他们对障碍和策略的看法进行探索和描述。因此，本文旨在探索、描述并结合具体情境阐述注册护士对年轻女性PrEP使用方面的卫生系统障碍和策略的看法。
方法
采用定性、探索性、描述性和情境性方法来探索和描述注册护士对医疗保健系统中PrEP使用的障碍和策略的看法。有目的地抽取参与者进行焦点小组讨论，并使用反思性主题分析对数据进行分析。
结果
关于PrEP使用的障碍和策略被报告为出现了八个子主题的主题。其中包括：医疗保健系统结构、医疗保健提供者、健康促进和药物相关障碍及策略。医疗保健系统结构障碍包括PrEP获取受限，与医护人员相关的包括培训、能力和人员配备，而健康促进方面包括认知度低、PrEP信息不准确、与抗逆转录病毒治疗（HIV-ART）相关的耻辱感。与药物相关的障碍是副作用、禁忌证和监测负担，这些对于提高PrEP的使用率至关重要，需要加以解决。此外，增加获取途径、将PrEP纳入现有的HIV、计划生育服务、对护士进行PrEP教育和培训等策略将有助于克服这些障碍。积极管理副作用、提高认知度、利用媒体平台传播信息、提供高质量咨询以及使用三个月注射一次的PrEP，以实现年轻女性对PrEP的理想使用率。
结论
研究结果报告了在焦点小组讨论中注册护士所表达的影响PrEP使用的医疗保健系统结构、医疗保健提供者、健康促进和药物相关障碍及策略。
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