"如果我被女孩拒绝了怎么办?我宁愿停药":津巴布韦 18-29 岁新感染艾滋病毒的成年人坚持抗逆转录病毒疗法的障碍和促进因素。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI:10.1080/09540121.2024.2332462
Rebecca Jopling, Wilson Mutsvuke, Madison Fertig, Conall O'Cleirigh, Walter Mangezi, Melanie Abas
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引用次数: 0

摘要

与老年人相比,18-29 岁的新兴成年人病毒抑制率高,抗逆转录病毒疗法的依从性也较差。我们对津巴布韦 24 名近期有病毒抑制史的新成人进行了半结构式访谈,以探讨坚持抗逆转录病毒疗法的障碍和促进因素。访谈采用归纳主题分析法进行编码。参与者的平均年龄为 23 岁,65% 为男性,79% 表示在出生时感染了艾滋病毒。共发现了 12 个妨碍坚持抗逆转录病毒疗法的障碍。由于披露可能带来的负面影响而隐瞒艾滋病病毒感染状况对坚持抗逆转录病毒疗法有很大影响。这对于正在建立亲密关系的成年人来说尤为重要。据报告,远离家乡、贫困、心理健康状况不佳、孤独、重大生活事件、酗酒、医疗系统障碍和污名化也是影响坚持治疗的障碍。在披露艾滋病病毒感染状况后,来自同伴和家人的支持、电话提醒、解决问题的坚持策略、了解其他艾滋病病毒感染者,这些都是坚持抗逆转录病毒疗法的促进因素。对药物的信念以及与医疗服务提供者的关系既是坚持治疗的障碍,也是坚持治疗的促进因素。减少耻辱感、促进同伴支持和治疗常见精神障碍的干预措施可促进 18-29 岁的新成人坚持抗逆转录病毒疗法。
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"What if I got rejected by the girl? I would rather stop the pills": barriers and facilitators of adherence to antiretroviral therapy for emerging adults aged 18-29 living with HIV in Zimbabwe.

Emerging adults aged 18-29 have high rates of viral non-suppression, and poorer adherence to ART when compared to older adults. Semi-structured interviews were conducted with 24 emerging adults in Zimbabwe who had a recent history of viral non-suppression, to explore barriers and facilitators of adherence to ART. Interviews were coded using inductive thematic analysis. The mean age of participants was 23, 65% were male, and 79% reported acquiring HIV at birth. Twelve barriers to adherence were identified. Hiding HIV status due to the possible negative consequences of disclosure had a significant impact on adherence to ART. This was particularly important for emerging adults navigating starting intimate relationships. Being away from home, poverty, poor mental health, isolation, significant life events, alcohol, health systems barriers, and stigma were reported as barriers to adherence. Support from peers and family after disclosure of HIV status, phone-based reminders, problem-solving strategies to adhere, knowing others living with HIV, acted as facilitators to adherence to ART. Beliefs about medicines and relationships with health care providers acted as both barriers and facilitators to adherence. Interventions to reduce stigma, foster peer support, and therapy for common mental disorders could facilitate emerging adults aged 18-29 to adhere to ART.

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