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HIV/AIDS treatment funding system to support the people affected by HIV/AIDS in Surakarta, Indonesia. 艾滋病毒/艾滋病治疗资助系统,以支持印度尼西亚泗水市受艾滋病毒/艾滋病影响的人。
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2020.1858946
Argyo Demartoto, Bhisma Murti, Siti Zunariyah

People Living with HIV/AIDS (PLWHA's) quality of life (QoL) is determined by the lifetime treatment sustainability. Republic of Indonesia Minister of Health's Decree Number 328 of 2003 stated that government subsidies the PLWHA's medication and treatment, despite not covering entire medication and treatment cost. The objective of research was to analyse the cost assumed by PLWHA in accessing HIV/AIDS treatment service in Surakarta, Indonesia. The target group in this case study was PLWHAs, and related stakeholders of medical treatment in one of Public Health Centers and a Public Hospital in Surakarta; AIDS Commission of Surakarta City; Solo Plus Peer Support Group and AIDS-Care NGO selected purposively. Data collection was carried out using observation, in-depth interview, and documentation. Method and data source triangulations were used to validate data that was then analysed using Grossman's Demand for Health Capital theory. The result of research showed that the sources of HIV/AIDS treatment cost were self-income, Social Insurance Administration Organization (BPJS) fund and Local Government subsidy. Admission and physican services are given for free to PLWHA because it has been paid by BPJS Fund or has been subsidied by Local Government. Otherwise, they should pay registration cost of IDR 50,000, in Public Hospital and IDR 75,000 in Private Hospital. Physician service costs IDR 50,000-IDR 200,000. VCT Counsellor costs IDR 35,000-IDR 150,000. Non-Subsidy ARV costs IDR 687,000. 1 bottle containing 60 TB meningitis drug capsules costs IDR 145,000 for 10-20 d use and maximally IDR 210,000, while herpes drug costs IDR 295,000. CD4 examination costs IDR 126,000-IDR 297,000, RNA Viral load IDR 1,275,000-IDR 1,471,000, Haematology IDR 60,000-IRD 90,000, Cholesterol and triglyceride IDR 100,000-IDR 250,000, and SGOT/SGPT IDR 100,000-IDR 200,000. There is monthly non-medical cost the patient should spend, including transportation cost to go to health centre, and food, beverage, and newspaper cost while waiting for the service. BPJS fund and local government subsidy relieved health economic burden of PLWHAs, so that the average HIV/AIDS treatment cost in PLWHAs was relatively low, less than 10% of expense. National Insurance System including BPJS fund and local government subsidy as the answer to the integration of HIV/AIDS treatment funding management into national insurance system had provided PLWHA a funding access involving prevention, care, support, and treatment, and mitigated the effect despite less optimum.

艾滋病毒/艾滋病感染者(PLWHA)的生活质量(QoL)取决于终生治疗的可持续性。印度尼西亚共和国卫生部长2003年第328号法令指出,政府补贴艾滋病患者的药品和治疗,尽管不支付全部药品和治疗费用。研究的目的是分析艾滋病毒/艾滋病感染者卫生组织在印度尼西亚苏拉卡塔获得艾滋病毒/艾滋病治疗服务方面承担的费用。本案例研究的目标群体是公共卫生机构,以及在一个公共卫生中心和泗水一所公立医院进行医疗的相关利益攸关方;泗水市艾滋病委员会;Solo Plus同伴互助小组和关爱艾滋病的非政府组织是有意选择的。数据收集采用观察法、深度访谈法和文献法。使用方法和数据源三角测量来验证数据,然后使用格罗斯曼的健康资本需求理论进行分析。研究结果表明,艾滋病治疗费用的来源主要为个人收入、社会保险经办机构(BPJS)基金和地方政府补贴。艾滋病规划署免费提供入院和医生服务,因为它是由艾滋病规划署基金支付的,或者是由地方政府补贴的。否则,在公立医院和私立医院分别支付注册费用50000印尼盾和75000印尼盾。医生服务费用为5万至20万印尼盾。VCT辅导员费用为35,000- 150,000印尼卢比。非补贴抗逆转录病毒药物费用为68.7万印尼盾。每瓶含有60粒结核性脑膜炎药物胶囊,使用10-20天的费用为14.5万印尼盾,最高为21万印尼盾,而疱疹药物的费用为29.5万印尼盾。CD4检查费用12.6万- 29.7万印尼盾,RNA病毒载量检查费用1,275,000- 1,471,000印尼盾,血液学检查费用60,000- 90,000印尼盾,胆固醇和甘油三酯检查费用100,000- 250,000印尼盾,SGOT/SGPT检查费用100,000- 200,000印尼盾。患者每月需要支付的非医疗费用包括前往保健中心的交通费,以及等待服务期间的食品、饮料和报纸费用。BPJS基金和地方政府补贴减轻了PLWHAs的卫生经济负担,使得PLWHAs的平均HIV/AIDS治疗费用较低,不到费用的10%。包括BPJS基金和地方政府补贴在内的国家保险制度作为将艾滋病毒/艾滋病治疗资金管理纳入国家保险制度的答案,为艾滋病毒/艾滋病感染者提供了包括预防、护理、支持和治疗在内的资金渠道,并减轻了效果,尽管效果并不理想。
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引用次数: 3
Maternal and infant antiretroviral therapy adherence among women living with HIV in rural South Africa: a cluster randomised trial of the role of male partner participation on adherence and PMTCT uptake. 南非农村艾滋病毒感染妇女的母婴抗逆转录病毒治疗依从性:一项男性伴侣参与对依从性和预防母婴传播接受作用的聚类随机试验。
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2020.1863854
Deborah L Jones, Violeta J Rodriguez, Manasi Soni Parrish, Tae Kyoung Lee, Stephen M Weiss, Shandir Ramlagan, Karl Peltzer

'Mother-to-child transmission of HIV' can occur during the period of pregnancy, childbirth, or breastfeeding. 'Prevention of mother-to-child transmission of HIV' (PMTCT) in Mpumalanga Province, South Africa, is especially vital as the prevalence of HIV is 28.2% in women aged 15-49. PMTCT interventions resulted in a drop of MTCT rates in Mpumalanga from ∼2% in 2015 to 1.3% in 2016. This randomised controlled trial in Mpumalanga examined the potential impact of a lay healthcare worker administered intervention, 'Protect Your Family', on maternal and infant adherence, and to assess the relative influence of male partner involvement on infant and maternal adherence. This cluster randomised controlled trial used a two-phase and two-condition (experimental or control) study design where participants (n = 1399) did assessments both during pregnancy and post-postpartum. Only women participated in Phase 1, and both female and male partners participated in Phase 2. Results indicated that male involvement was associated with self-reported maternal or infant antiretroviral therapy (ART) adherence, but the intervention was not associated with ART adherence. Self-reported adherence was associated with depression, age, and partner HIV status. The study results provide support for the involvement of men in the antenatal clinic setting during pregnancy. Results also support further research on the meaning and assessment of male involvement and clarification of the constructs underlying the concept in the sub-Saharan African context. Outcomes provide support for male involvement and treatment of depression as adjuncts to improve uptake of both maternal and infant medication as part of the PMTCT protocol.

“艾滋病毒母婴传播”可能发生在怀孕、分娩或哺乳期间。南非姆普马兰加省的“预防母婴传播艾滋病毒”(PMTCT)尤其重要,因为15-49岁妇女的艾滋病毒感染率为28.2%。预防母婴传播干预措施使姆普马兰加省的母婴传播率从2015年的2%下降到2016年的1.3%。这项在姆普马兰加进行的随机对照试验检查了非专业卫生保健工作者管理的干预措施“保护你的家庭”对母婴依从性的潜在影响,并评估了男性伴侣参与对母婴依从性的相对影响。该整群随机对照试验采用两阶段和两条件(实验或对照)研究设计,参与者(n = 1399)在怀孕期间和产后进行评估。第一阶段只有女性参与,第二阶段男女双方都参与。结果表明,男性参与与自我报告的母亲或婴儿抗逆转录病毒治疗(ART)依从性有关,但干预与ART依从性无关。自我报告的依从性与抑郁、年龄和伴侣艾滋病毒状况有关。研究结果为男性在怀孕期间参与产前门诊提供了支持。研究结果还支持进一步研究男性参与的意义和评估,并澄清撒哈拉以南非洲背景下这一概念的基本概念。结果为男性参与和治疗抑郁症提供了支持,作为预防母婴传播方案的一部分,以改善母婴药物的吸收。
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引用次数: 4
Underlying reasons why some people haven't tested for HIV - a discourse analysis of qualitative data from Cape Town, South Africa. 一些人没有进行艾滋病毒检测的潜在原因——对南非开普敦定性数据的话语分析。
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2021.1977686
Kyla Meyerson, Graeme Hoddinott, Tamryn Nicholson, Sue-Ann Meehan

Reported barriers to HIV testing over the last 15 years have remained consistent, despite improved service offerings. We aimed to probe deeper by exploring how people who have never tested construct HIV testing in their talk. We used this to suggest underlying psychosocial barriers to testing even when there is high availability. We enrolled 14 participants who reported that they had never tested for HIV and conducted individual, open-ended interviews. The data were organised thematically with theory-generative interpretations informed by discourse analysis. Reasons for not testing reported reflect similar barriers identified in previous research. Deeper probing identified three discursive processes by which participants explained why they had never tested for HIV, suggesting that the way participants used 'reasons' in their talk is an indicator that the participants were repeating 'tropes'. While aware of HIV testing facilities, participants still chose not to test. Influences on the choice to test or not were positioned as outside of the person's control. These findings suggest that there are deeper reasons why some people have not tested and that these will not be resolved through merely increasing accessibility to testing services. We recommend increased consideration of the psychosocial implications of testing in service delivery.

在过去15年中,尽管提供的服务有所改善,但报告的艾滋病毒检测障碍仍然存在。我们的目标是通过探索从未检测过的人如何在他们的谈话中构建艾滋病毒检测来进行更深入的探索。我们用它来提示潜在的心理障碍测试,即使有很高的可用性。我们招募了14名参与者,他们报告说他们从未检测过艾滋病毒,并进行了个人的开放式访谈。数据按主题组织,并通过语篇分析提供理论生成解释。未检测报告的原因反映了先前研究中发现的类似障碍。更深入的探索发现了参与者解释为什么他们从未检测过艾滋病毒的三个话语过程,这表明参与者在他们的谈话中使用“理由”的方式表明参与者在重复“比喻”。虽然知道艾滋病检测设施,但参与者仍然选择不进行检测。选择测试或不测试的影响被定位为不在个人控制范围之内。这些发现表明,有些人没有接受检测有更深层次的原因,而这些原因不能仅仅通过增加检测服务的可及性来解决。我们建议在提供服务时更多地考虑检测的社会心理影响。
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引用次数: 0
Knowledge, attitudes and prevention practices regarding HIV/AIDS among barbers in Ho municipality, Ghana. 加纳 Ho 市理发师对艾滋病毒/艾滋病的认识、态度和预防措施。
IF 1.8 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2021.1883101
Mercy Demaris Quarm, Jacqueline Mthembu, Khangelani Zuma, Elvis Enowbeyang Tarkang

The barbing industry poses particular public health risks if it is not conducted in a safe and hygienic manner. These risks can lead to the transmission of infectious diseases like the Human Immunodeficiency Virus (HIV) to the barbers or their clients. This study investigated the knowledge, attitudes and prevention practices regarding HIV transmission among barbers in the Ho Municipality. A descriptive cross-sectional design was employed. A pretested structured questionnaire was administered to a consented sample of barbers sampled using a multistage random sample design. Descriptive and inferential statistics were performed using Stata version 14.0 software programme where 0.05 level was used as a measure of significance. The knowledge level of the barbers regarding HIV/AIDS was inadequate (63.6%). Knowledge was significantly associated with work experience [AOR = 13.56 (95% CI: 2.73-67.25); p = 0.001], with attitude [AOR = 4.07 (95% CI: 1.27-13.08); p = 0.018], with level of education [AOR = 10.22 (95% CI: 2.24-46.64); p = 0.003], with marital status [AOR = 0.07 (95% CI: 0.01-0.50); p = 0.008] and with number of clients per day [AOR = 0.13 (95% CI: 0.03-0.52); p = 0.004]. The attitude of barbers was also inadequate (58.7%). Attitude was significantly associated with the mode of learning the barbing profession [AOR = 0.32 (95% CI: 0.11-0.89); p = 0.029], and with level of knowledge [AOR = 5.48 (95% CI: 2.01-14.93); p = 0.001]. Majority of the participants exhibited poor prevention practices regarding HIV/AIDS (87.6%). Prevention practice was significantly associated with work experience [AOR = 24.92 (95% CI: 2.08-297.86); p = 0.011] and with level of knowledge [AOR = 12.57 (95% CI: 1.35-116.86); p = 0.026]. The barbers in Ho exhibited inadequate knowledge and attitude regarding HIV/AIDS, and also manifested poor prevention practices regarding HIV/AIDS. Programmes aimed at improving the knowledge, attitudes and prevention practices should be implemented among barbers, with focus on those without any formal education, those with less than five years work experience and those with more than ten clients a day.

理发业如果不以安全和卫生的方式进行,就会对公众健康构成特别的风险。这些风险可能导致人类免疫缺陷病毒(HIV)等传染病传播给理发师或其顾客。本研究调查了何市理发师对艾滋病传播的认识、态度和预防措施。研究采用了描述性横断面设计。采用多阶段随机抽样设计,对经过同意的理发师样本进行了预先测试的结构化问卷调查。使用 Stata 14.0 版软件程序进行了描述性和推论性统计,显著性水平为 0.05。理发师对艾滋病毒/艾滋病的了解程度不足(63.6%)。知识水平与工作经验[AOR = 13.56 (95% CI: 2.73-67.25); p = 0.001]、态度[AOR = 4.07 (95% CI: 1.27-13.08); p = 0.018]、教育水平[AOR = 10.22 (95% CI: 2.24-46.64); p = 0.003]、婚姻状况[AOR = 0.07 (95% CI: 0.01-0.50); p = 0.008]和每天的客户数量[AOR = 0.13 (95% CI: 0.03-0.52); p = 0.004]。理发师的态度也不够端正(58.7%)。态度与理发师职业学习方式[AOR = 0.32 (95% CI: 0.11-0.89); p = 0.029]和知识水平[AOR = 5.48 (95% CI: 2.01-14.93); p = 0.001]有明显相关性。大多数参与者(87.6%)对艾滋病毒/艾滋病的预防方法不佳。预防措施与工作经验[AOR = 24.92 (95% CI: 2.08-297.86); p = 0.011]和知识水平[AOR = 12.57 (95% CI: 1.35-116.86); p = 0.026]明显相关。何氏理发师对艾滋病毒/艾滋病的认识和态度不足,在艾滋病毒/艾滋病的预防方面也表现不佳。应在理发师中实施旨在改善知识、态度和预防措施的计划,重点关注未受过任何正规教育、工作经验少于五年以及每天接待客人超过 10 人的理发师。
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引用次数: 0
Sexual risk behaviour and its correlates among adolescents in Mozambique: results from a national school survey in 2015. 莫桑比克青少年的性风险行为及其相关因素:2015年全国学校调查结果
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2020.1858947
Supa Pengpid, Karl Peltzer

The study aimed to assess the prevalence and correlates of sexual risk behaviours among adolescents in Mozambique. In the cross-sectional 'Global School-Based Health Survey (GSHS)', 1918 students aged 11-18 years from Mozambique responded to a questionnaire in 2015. More than half (57.4%) of the students ever had sex, 68.4% among boys and 45.8% among girls. Among students who ever had sex, 41.5% had early sexual debut (<14 years), 57.9% had multiple sexual partners, 25.0% had not used a condom and 42.0% had not used birth control at last sex, and 59.4% engaged in multiple sexual risk behaviour. In adjusted logistic regression analysis, alcohol use, school truancy, older age and male sex were associated with multiple sexual risk behaviours. A large number of adolescents in Mozambique reported sexual risk behaviours, emphasising the need for interventions.

该研究旨在评估莫桑比克青少年性风险行为的流行程度及其相关因素。在“全球校本健康调查(GSHS)”横断面调查中,来自莫桑比克的1918名11-18岁学生于2015年回答了一份问卷。超过一半(57.4%)的学生有过性行为,其中男生占68.4%,女生占45.8%。有过性行为的学生中,有41.5%的人有性行为过早(
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引用次数: 10
Exploring the views of academic staff on HIV/AIDS integration into the curricula: a case study of the University of Fort Hare. 探讨学术人员对HIV/AIDS课程整合的看法:以Fort Hare大学为例。
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-12-01 DOI: 10.1080/17290376.2021.1951342
Zukiswa Theodorah Dasheka, Nomzamo Dube, Lulekwa Baleni, Eunice Seekoe, Actor Katurura, Nombulelo Lubisi, Daniel Ter Goon

As a clarion call by Higher Education HIV/AIDS programme (HEAIDS) to South African universities, entrenching, integration and infusing the teaching and learning of HIV/AIDS in the curriculum of universities prove to be a sustainable solution to changing risky behaviour and attitudes of university students towards HIV/AIDS. The majority of students in South African universities lack general awareness and education in HIV/AIDS. This raises the need to produce graduates who are knowledgeable and have a positive attitude regarding HIV/AIDS. A pilot study on HIV/AIDS curriculum integration at the University of Fort Hare involved academic staff was done. A qualitative case study approach was used to describe the process and effectiveness of the curriculum integration process. The data collection was through evaluation forms, reports and a focus group interview. Data were analysed using content analysis. Guskey's model for professional development was followed to understand the process and effect of curriculum integration. Initially, the academic staff anticipated that the HIV/AIDS curriculum integration process would result in credit overload for students, time constraints and increased workload. Later, most academic staff affirmed the benefits of being involved in the project such as improving teaching and facilitation styles and research.

作为高等教育艾滋病毒/艾滋病方案(HEAIDS)向南非大学发出的号召,在大学课程中巩固、整合和灌输艾滋病毒/艾滋病的教学被证明是改变大学生对艾滋病毒/艾滋病的危险行为和态度的可持续解决办法。南非大学的大多数学生缺乏对艾滋病毒/艾滋病的普遍认识和教育。这就需要培养对艾滋病毒/艾滋病有知识和积极态度的毕业生。在黑尔堡大学进行了一项涉及学术人员的关于艾滋病毒/艾滋病课程整合的试点研究。采用定性案例研究方法描述课程整合的过程和效果。数据收集是通过评估表格,报告和焦点小组访谈。数据采用内容分析法进行分析。遵循Guskey的专业发展模型来理解课程整合的过程和效果。最初,教职员预计艾滋病毒/艾滋病课程整合过程将导致学生学分超载、时间限制和工作量增加。后来,大多数学术人员肯定了参与项目的好处,如改善教学和促进方式以及研究。
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引用次数: 0
Anticipating Policy, Orienting Services, Celebrating Provision: Reflecting on Scotland’s PrEP Journey 预测政策,定位服务,庆祝供应:苏格兰PrEP之旅的反思
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-07-27 DOI: 10.1007/978-3-030-69819-5_5
I. Young
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引用次数: 1
The Drive to Take an HIV Test in Rural Uganda: A Risk to Prevention for Young People? 在乌干达农村进行艾滋病毒检测:对年轻人的预防风险?
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-07-27 DOI: 10.1007/978-3-030-69819-5_19
S. Bernays, Allen Asiimwe, Edward Tumwesige, J. Seeley
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引用次数: 1
An Unfinished History: A Story of Ongoing Events and Mutating HIV Problems 未完成的历史:一个正在发生的事件和变异的艾滋病问题的故事
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-07-27 DOI: 10.1007/978-3-030-69819-5_21
M. Rosengarten
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引用次数: 0
Public Secrets and Private Sufferings in the South African AIDS Epidemic 南非艾滋病流行中的公共秘密和私人痛苦
IF 1.1 4区 医学 Q4 HEALTH POLICY & SERVICES Pub Date : 2021-01-01 DOI: 10.1007/978-3-030-69437-1
John H. Stadler
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引用次数: 0
期刊
Sahara J-Journal of Social Aspects of Hiv-Aids
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