Ekusai-Sebatta Deborah, Kiragga Agnes N, Odongpiny Eva Laker Agnes, Namugenyi Ritah Shanice, Byakika-Kibwika Pauline, Seeley Janet, King Rachel
College of Health Sciences, Infectious Diseases Institute, Makerere University, Kampala, Uganda.
College of Health Sciences, Makerere University, Kampala, Uganda.
AIDS Care. 2025 Aug;37(8):1355-1365. doi: 10.1080/09540121.2025.2532600. Epub 2025 Jul 30.
This study examines the perceptions and experiences of health workers and caregivers regarding the delivery of long-acting antiretroviral therapy (LA-ART) in Uganda, especially for preventing vertical transmission of HIV. Using a qualitative implementation research design informed by the Health Belief Model, the researchers conducted 17 key informant interviews with clinicians, nurses, peer mothers, social workers, department heads, and lead researchers across six study centers between May 2022 and September 2023. The interviews were recorded and transcribed verbatim into English language and analyzed thematically using NVivo 14. Five key themes emerged: perceived benefits, perceived barriers, facility readiness, and recommendations for implementation. Health workers highlighted benefits such as treatment convenience, improved adherence, and patient acceptance. However, they also identified major barriers, including stigma, limited staff training, and financial constraints. Concerns about health facility readiness particularly cold chain storage for the injectable medication were also noted. The findings underscore the importance of addressing these challenges to support effective LA-ART delivery. The study recommends comprehensive training for healthcare workers, patient education, and a phased rollout strategy. Understanding the views of frontline workers is crucial for the successful integration of LA-ART into HIV care and improving health outcomes for people living with HIV.
本研究考察了乌干达卫生工作者和护理人员对长效抗逆转录病毒疗法(LA-ART)给药的看法和体验,尤其是关于预防艾滋病毒的垂直传播。研究人员采用基于健康信念模型的定性实施研究设计,于2022年5月至2023年9月期间,在六个研究中心对临床医生、护士、同伴母亲、社会工作者、部门负责人和首席研究员进行了17次关键 informant访谈。访谈进行了录音,并逐字转录成英语,使用NVivo 14进行主题分析。出现了五个关键主题:感知到的益处、感知到的障碍、机构准备情况以及实施建议。卫生工作者强调了治疗便利性、依从性提高和患者接受度等益处。然而,他们也指出了主要障碍,包括耻辱感、工作人员培训有限和资金限制。还提到了对医疗机构准备情况的担忧,特别是注射用药物的冷链储存。研究结果强调了应对这些挑战以支持有效实施LA-ART的重要性。该研究建议对医护人员进行全面培训、开展患者教育以及分阶段推出策略。了解一线工作人员的观点对于将LA-ART成功纳入艾滋病毒护理并改善艾滋病毒感染者的健康结果至关重要。