对哈萨克斯坦注射吸毒者(PWID)中艾滋病病毒感染者坚持抗逆转录病毒疗法(ART)的障碍和促进因素进行定性分析。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES Aids Care-Psychological and Socio-Medical Aspects of Aids/hiv Pub Date : 2024-10-15 DOI:10.1080/09540121.2024.2414078
Paige Neuenschwander, Fredrick L Altice, Robert H Remien, Gaukhar Mergenova, Lyailya Sarsembayeva, Elena Rozental, Valeriy Gulyayev, Alissa Davis
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引用次数: 0

摘要

注射毒品的艾滋病病毒感染者(PWH)在坚持抗逆转录病毒疗法方面面临许多障碍。哈萨克斯坦是世界上艾滋病疫情增长最快的国家之一,其主要原因是注射吸毒,但注射吸毒者坚持抗逆转录病毒疗法的比例却很低。社会支持可以帮助解决这些障碍,但很少有人在关系背景下研究感染者坚持抗逆转录病毒疗法的情况。我们对 20 名感染艾滋病病毒的吸毒者及其 18 名亲密伴侣进行了访谈,并对他们的关系进行了定性分析,以研究坚持抗逆转录病毒疗法的因素。结果表明,在个人层面(如药物使用)、人际层面(如社会支持)和结构层面(如污名化、交通)存在许多坚持抗逆转录病毒疗法的障碍和促进因素。伴侣间报告的坚持治疗的障碍和促进因素具有很高的一致性;但是,伴侣间也发现了一些明显的差异。与艾滋病感染者相比,未感染艾滋病的伴侣对污名在阻碍坚持抗逆转录病毒疗法方面的作用缺乏认识。在血清反应一致的伴侣(如一起服药、一起赴约)和血清反应不一致的伴侣(如提醒服药、提供看护以便赴约就医)之间,促进坚持抗逆转录病毒疗法的社会支持有不同的表现形式。未来的研究和计划可能会受益于在抗逆转录病毒疗法的坚持治疗干预中采用二人一组的方法。
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A qualitative dyad analysis of barriers and facilitators of antiretroviral therapy (ART) adherence among people who inject drugs (PWID) with HIV in Kazakhstan.

People with HIV (PWH) who inject drugs (PWID) face many barriers to ART adherence. Kazakhstan has one of the fastest growing HIV epidemics in the world, primarily fueled by injection drug use, yet ART adherence among PWID is low. Social support can help address these barriers, but ART adherence among PWID is rarely examined within the relationship context. We conducted interviews with 20 PWID with HIV and 18 of their intimate partners and performed a qualitative dyad analysis to examine ART adherence factors. The results indicated many barriers and facilitators of ART adherence at the individual level (e.g., substance use), interpersonal level (e.g., social support) and structural level (e.g., stigma, transportation). Reported adherence barriers and facilitators had high congruence between dyad members; however, some notable differences were found between dyads. Compared to PWH, partners without HIV had a lack of awareness about the role of stigma in impeding ART adherence. Different manifestations of social support to facilitate ART adherence were noted between seroconcordant dyads (e.g., taking pills together, attending appointments together) and serodiscordant dyads (e.g., reminders to take pills, providing babysitting to enable attendance at doctor appointments). Future research and programs may benefit from integrating dyad approaches into ART adherence interventions.

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