Ajar-African Journal of Aids Research最新文献

HIV-related stigmatisation is common in many parts of the world and is experienced by all categories of people living with HIV and AIDS (PLWHA). Although the negative consequences of HIV-related stigmatisation on the resilience of PLWHA is well documented, little is known about the plausible role of certain personal characteristics in moderating the stigma-resilience relationship. In addition to investigating the direct association of HIV-related stigma (personalised stigma, disclosure concern, concern about public attitude and negative self-image) with resilience, the present study examined whether psychological flexibility (PF) moderates the HIV-related stigmaresilience relationship among PLWHA. Participants included 280 PLWHA (M = 39.48; SD = 9.03) selected from Sacred Heart Catholic Hospital (SHCH), Obudu, Cross River State, Nigeria. Participants completed relevant self-report measures. Results showed that patients reported moderately high levels of resilience (M = 59.13; SD = 13.98). Hierarchical multiple regression analysis showed that HIV-related stigma (personalised stigma, disclosure concern and concern about public attitudes) were not significantly associated with resilience (p = 0.230; p = 0.747; p = 0.528). HIV-related negative self-image and PF were independently and significantly associated with resilience (p = 0.024; p = 0.000). Results of moderation hypothesis revealed that PF did not moderate the relationship between HIV-related disclosure concern and resilience (p = 0.903), and between HIV-related concern about public attitudes and resilience (p = 0.905), but PF moderated the relationship of HIV-related personalised stigma and resilience (p = 0.023), and the relationship of HIV-related negative self-image and resilience (p = 0.004). Therefore, interventions to promote resilience abilities in PLWHA should consider facilitating patients' psychological flexibility skills as it is critical in decreasing the hazardous effect of HIV-related stigma on the patients.

Background: Reaching all people with HIV services, including traders in the informal economy, is critical to meeting UNAIDS' 95-95-95 goals. However, traders prioritise their business over attendance at health facilities. This limits their access to health services. This study explores market traders' preferences for the potential type and delivery methods of HIV services at Lilongwe Central market.Method: The study used an exploratory qualitative study design in Lilongwe, Malawi. Sixteen in-depth interviews were conducted among traders at Lilongwe Central Market between June and September 2022. In the same period, we also conducted four key informant interviews involving three officers responsible for HIV services at the district and council levels, and the market chairman.Results: HIV services preferred by market traders include HIV testing, antiretroviral therapy, condom dispensation, voluntary medical male circumcision and HIV awareness campaigns. These services should be offered daily or when the market is less crowded, and they could be delivered in the market. These services can be provided by both lay and health workers, depending on traders' preferences, and must be integrated with other health services to mitigate unintended HIV status disclosure concerns.Conclusion: The achievement of UNAIDS' 95-95-95 goals by 2030 requires that HIV services should be available to all those who require them at times and locations that are convenient for them, through providers they have chosen either as integrated or standalone, depending on the target group perception of the role of these two models in mitigating stigma. This will necessitate the development of new approaches targeting underserved groups, such as traders in markets.

Background: Globally, efforts to curtail the HIV pandemic are growing. The Joint United Nations Programme on HIV and AIDS (UNAIDS) and partners set the 95-95-95 targets to be achieved by 2025. Tanzania's ongoing transition from single-month ARV to longer multi-month dispensing (MMD) involves significant planning and shifts in existing resources, including health commodities, clinical staff and storage space. This study aimed at evaluating the costs and efficiency gains of rolling out MMD compared to the prior monthly dispending (MD) standard of care before the new guidelines.Methods: The analysis employed a health provider perspective utilising prior costing data collected to estimate cost of treatment for HIV/AIDS, including salaries, laboratory costs, antiretroviral drugs, other supplies and overhead costs. The projections were run from 2018 to 2030 using the Spectrum package for Tanzania.Results: Our model estimated that total treatment cost without MMD (including salaries, laboratory costs, antiretroviral drugs, other supplies, and overhead costs) is estimated to rise from USD 189 million in 2018 to USD 244 million in 2030. The introduction of a six-month MMD would lead to the total annual facility-based treatment costs being reduced to USD 205 million in 2030. When comparing MD to a six-month MMD, the total savings over the 13-year period would be USD 425 million. The introduction of six-month MMD for stable patients would reduce the average cost from USD 180 to USD 156 per patient per year if stable patients were only required to make six-monthly visit.Conclusions: The introduction of differentiated service delivery models (DSDMs) and MMD is already contributing to significant cost savings for Tanzania and will continue to do so as the country puts more stable patients on MMD. The potential gains from MMD implantation could further be harnessed if retention of treatment and viral suppression monitoring are prioritised.