COVID-19 大流行对坦桑尼亚达累斯萨拉姆一家三级医院就诊青少年艾滋病毒护理和治疗服务的影响:一项定性研究

Eva Kidabulo, Lilian Nkinda, D. Mwakawanga, Agricola Joachim
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摘要

COVID-19 大流行对艾滋病毒护理和治疗计划造成了严重破坏,尤其是对感染艾滋病毒的青少年(ALHIV)而言,众所周知,与成年人相比,他们的健康状况较差。大流行病的出现中断了青少年友好型医疗保健服务,这阻碍了为克服原有挑战所做的努力。因此,本研究旨在从坦桑尼亚达累斯萨拉姆一家三甲医院的医疗服务提供者和青少年的经验出发,评估大流行病对艾滋病护理和治疗服务的影响。在招募医疗服务提供者和青少年时,分别采用了有目的抽样和方便抽样技术。采用斯瓦希里语半结构式访谈指南进行访谈。研究显示,在 COVID-19 大流行期间,医疗保健提供方式的改变以及医疗保健机构有限的人力和非人力资源降低了医疗保健的有效性和质量,导致青少年不能坚持服药和失去随访机会。我们的研究结果强调了COVID-19及其直接应对措施对青少年艾滋病护理和治疗服务的影响。加强可持续的 ALHIV 计划并为这些计划提供资金支持,对于在流行病期间促进保留和参与护理工作至关重要。
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Impacts of the COVID-19 pandemic on HIV care and treatment services among adolescents attending a tertiary hospital in Dar es Salaam, Tanzania: a qualitative study
The COVID-19 pandemic has caused substantial disruption on HIV care and treatment programmes, especially for adolescents living with HIV (ALHIV) who are known to have poorer health outcomes compared with adults. Efforts made to overcome the pre-existing challenges were hampered by the emergence of the pandemic which interrupted adolescent-friendly healthcare services. Therefore, the aim of this study was to assess the impacts of the pandemic on HIV care and treatment services from healthcare providers and adolescents’ experiences at a tertiary hospital in Dar es Salaam, Tanzania.A descriptive qualitative study using in-depth interviews was conducted with 17 study participants. Purposive and convenient sampling techniques were used to recruit healthcare providers and adolescents, respectively. Swahili semistructured interview guide was used to conduct interviews. Thematic analysis was conducted to generate themes and subthemes describing the experiences on effects brought by COVID-19 on HIV care and treatment among adolescents.The study revealed that alteration of approach in delivery of healthcare and limited human and non-human resources in healthcare facilities during the COVID-19 pandemic decreased effectiveness and quality of care which resulted in adolescent’s poor adherence to medication and loss to follow-up. Loss of family income, food insecurity and limited socialisation posed threat to adolescent’s mental health and overall quality of life.Our findings underscore the impacts of COVID-19 and its immediate responses that significantly affected adolescent HIV care and treatment services. Reinforcement of sustainable ALHIV programmes and funding supports to these programmes are essential to promote retention and engagement to care during pandemics.
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