乌干达卡塞塞区选定医疗机构中客户加入社区客户主导的抗逆转录病毒疗法(CCLAD)的障碍

Kizito Omona
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摘要

背景:社区患者主导的抗逆转录病毒疗法提供模式(CCLAD)与社区参与度和自主权的提高有关,这种模式可通过减少工作量和提高患者对医疗服务的满意度来改善治疗效果。目的:在乌干达卡塞塞区选定的医疗机构中,探讨符合条件的患者加入 CCLAD 的障碍。材料与方法:采用混合方法对 384 名在卡塞塞区公共医疗机构就诊的 PLWHIV 进行了横断面分析研究。抽样采用简单随机抽样法。采用研究人员发放的问卷调查法和访谈指南收集数据。结果大多数受访者有 253 人(65.9%)尚未加入 CCLAD。这是由于一些与客户相关的因素造成的,如未披露 HIV 血清状况(p=0.040)、向谁披露了 HIV 血清状况(p=0.009)、从未听说过 CCLAD(p=0.000)、对 CCLAD 的描述不正确(p=0.000)、对 CCLAD 的优点(p=0.000)或缺点(p=0.003)了解有限。其他障碍包括:无法接触支持 PLWHIV 接受治疗的组织或团体(p=0.025),以及抗逆转录病毒疗法续药时间[AOR=1.637,95% CI (0.820 - 3.270)]。结论卡塞塞地区的艾滋病毒感染者对CCLAD模式的采用率仍然很低。关键词社区客户主导的抗逆转录病毒疗法(CCLAD);注册;医疗保健与公共卫生。
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Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese District, Uganda
Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services. Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda. Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide. Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 – 3.270)]. Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low. Keywords: Community client led anti-retroviral therapy delivery (CCLAD); enrolment; health care and public health.
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