Bedingar Esias, Paningar Ferdinan, Bedingar Ngarossorang, Mbaidoum Eric, Ngaradoum Naortangar, Atun Rifat, Yousafzai Aisha K
Global Health and Population Department, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
Alma, Centre de Recherche en Systèmes de Santé, N'Djamena, Chad.
PLoS One. 2025 Jun 24;20(6):e0309497. doi: 10.1371/journal.pone.0309497. eCollection 2025.
Youth ages 15-24 years are significantly impacted by the HIV/AIDS epidemic, representing approximately 37% of new infections globally. This demographic is especially vulnerable in sub-Saharan Africa, where over 80% of HIV-positive youth reside. In Chad, youth face barriers to effective HIV care, including high prevalence rates, particularly among young women, and substantial disparities across regions. Despite overall reductions in new HIV infections, youth remain disproportionately affected, necessitating targeted interventions to improve HIV care outcomes. This study represents a secondary data analysis derived from a parent study that employed a grounded theory design to develop theory inductively. The secondary analysis aimed to generate an in-depth understanding of the pathways to care for youth in Chad, exploring barriers and facilitators across the care continuum, from diagnosis to antiretroviral therapy (ART) adherence. Data were collected through focus group discussions with 52 youth and 48 service providers, including healthcare workers and community actors. Data were transcribed, translated, and analyzed assisted with ATLAS.ti software (Version 7.6.3). Youth identified barriers such as financial constraints, logistical challenges, and fear of stigma, while facilitators included peer support and specialized HIV care facilities. Healthcare workers emphasized the critical role of psychosocial counseling and confidentiality in facilitating youth engagement with HIV services. They also highlighted critical challenges, including the lack of accessible and youth-friendly services, and the need for continuous education to reduce stigma. The findings underscore the importance of tailored, youth-friendly interventions that address these challenges, foster supportive environments, and integrate youth and provider perspectives. We recommend redesigning healthcare services to improve accessibility, reduce stigma, and provide continuous psychosocial support, ultimately enhancing the HIV care continuum for youth in Chad and similar contexts.
15至24岁的年轻人受艾滋病毒/艾滋病疫情的影响尤为严重，约占全球新感染病例的37%。这一人群在撒哈拉以南非洲尤其脆弱，那里80%以上的艾滋病毒呈阳性的年轻人居住于此。在乍得，年轻人在获得有效的艾滋病毒治疗方面面临障碍，包括高感染率，尤其是在年轻女性中，以及各地区之间存在的巨大差异。尽管新的艾滋病毒感染总体有所减少，但年轻人仍然受到不成比例的影响，因此需要有针对性的干预措施来改善艾滋病毒治疗效果。本研究是一项二次数据分析，源自一项采用扎根理论设计进行归纳式理论构建的母研究。二次分析旨在深入了解乍得年轻人的治疗途径，探讨从诊断到抗逆转录病毒疗法（ART）依从性整个治疗过程中的障碍和促进因素。通过与52名年轻人和48名服务提供者（包括医护人员和社区工作者）进行焦点小组讨论收集数据。数据进行了转录、翻译，并借助ATLAS.ti软件（版本7.6.3）进行分析。年轻人指出了诸如经济限制、后勤挑战和对污名化的恐惧等障碍，而促进因素包括同伴支持和专门的艾滋病毒治疗设施。医护人员强调了心理社会咨询和保密性在促进年轻人参与艾滋病毒服务方面的关键作用。他们还突出了关键挑战，包括缺乏方便且适合年轻人的服务，以及需要持续教育以减少污名化。研究结果强调了量身定制、适合年轻人的干预措施的重要性，这些措施应应对这些挑战、营造支持性环境并整合年轻人和提供者的观点。我们建议重新设计医疗服务，以提高可及性、减少污名化并提供持续的心理社会支持，最终加强乍得及类似环境中年轻人的艾滋病毒治疗连续过程。
Cochrane Database Syst Rev. 2022-10-4
Cochrane Database Syst Rev. 2005-4-18
Front Public Health. 2025-6-10
BMC Prim Care. 2022-11-23
Zotero 插件