Duffy Meghan, Xavier Etevaldo M F, de Almeida Anabela, Correia Della, Nhavane Dos Prazeres Maria, Adriano Jacinto, Parruque Bainabo, Bule Maria Olga, Denhard Langan, Almeida Maura, Baptista Ana, Cossa de Pinho Raquel
Division of Global HIV & TB, U.S. Centers for Disease Control and Prevention (CDC), Maputo, Mozambique.
Friends in Global Health, Maputo, Mozambique.
J Int AIDS Soc. 2025 Jun;28 Suppl 1(Suppl 1):e26452. doi: 10.1002/jia2.26452.
In Mozambique, post-exposure prophylaxis (PEP) to prevent HIV is offered as part of the essential package of post-violence care services at 1450 health facilities. However, HIV PEP access and adherence continue to be a challenge. Healthcare providers were interviewed to identify and synthesize their recommendations for improving PEP access and adherence.
We conducted semi-structured, in-depth interviews with 20 adolescent and adult healthcare providers (3 men and 17 women) who had a range of 2-15 years of experience from 20 health facilities across seven provinces during March-August 2023. Data were analysed using inductive and theoretical thematic analysis. We analysed how frequently health providers mentioned specific recommendations.
Regarding PEP access, healthcare providers recommended community education as the most effective strategy (10 mentions). In particular, providers cited the importance of palestras [community health talks]. Providers also commonly highlighted the need to have PEP kits prepared (7 mentions) and PEP readily available at health facilities (6 mentions). Regarding PEP adherence, providers recommended client counselling/education (13 mentions) to ensure clients understand the importance of taking PEP, how to properly take PEP and the potential side effects, which can often deter clients from adhering. Additionally, providers highlighted chamadas preventivas [follow-up telephone calls] within 2 weeks or so after the initial visit (9 mentions) as the best means to ensure clients complete the full, 28-day regimen and return for retesting after 3 months. Healthcare providers explained that follow-up telephone calls, despite the client living far from the health facility, can create a bond that supports clients. Providers recommended the institutionalization of follow-up telephone calls for consistent implementation in all healthcare facilities that offer PEP.
Interviewed healthcare providers offered valuable insights and recommendations to improve PEP access and adherence, which could be considered for implementation in Mozambique and other sub-Saharan African countries.
在莫桑比克，1450家医疗机构将预防艾滋病毒的暴露后预防（PEP）作为暴力后护理服务基本套餐的一部分提供。然而，获得艾滋病毒暴露后预防药物及坚持服药仍然是一项挑战。我们对医疗服务提供者进行了访谈，以确定并综合他们关于改善获得艾滋病毒暴露后预防药物及坚持服药情况的建议。
2023年3月至8月期间，我们对来自七个省份20家医疗机构、拥有2至15年工作经验的20名青少年及成年医疗服务提供者（3名男性和17名女性）进行了半结构化的深入访谈。使用归纳和理论主题分析法对数据进行分析。我们分析了医疗服务提供者提及具体建议的频率。
关于获得艾滋病毒暴露后预防药物，医疗服务提供者推荐社区教育是最有效的策略（提及10次）。特别是，提供者提到了社区健康讲座的重要性。提供者还普遍强调需要准备好暴露后预防药物试剂盒（提及7次）以及在医疗机构随时提供暴露后预防药物（提及6次）。关于坚持服用暴露后预防药物，提供者推荐对客户进行咨询/教育（提及13次），以确保客户了解服用暴露后预防药物的重要性、如何正确服用暴露后预防药物以及潜在的副作用，这些往往会使客户不愿坚持服药。此外，提供者强调在初次就诊后约2周内进行预防性随访电话（提及9次）是确保客户完成完整的28天疗程并在3个月后返回进行重新检测的最佳方式。医疗服务提供者解释说，尽管客户住得离医疗机构很远，但随访电话可以建立一种支持客户的联系。提供者建议将随访电话制度化，以便在所有提供暴露后预防药物的医疗机构中持续实施。
接受访谈的医疗服务提供者提供了关于改善获得艾滋病毒暴露后预防药物及坚持服药情况的宝贵见解和建议，莫桑比克和其他撒哈拉以南非洲国家可考虑予以实施。
