'It is scary to pause treatment': perspectives on HIV cure-related research and analytical treatment interruptions from women diagnosed during acute HIV in Durban, South Africa.

IF 1.7 4区 医学 Q3 INFECTIOUS DISEASES
HIV Research & Clinical Practice Pub Date : 2025-12-01 Epub Date: 2025-01-25 DOI:10.1080/25787489.2025.2455917
Deli Mthimkhulu, Krista L Dong, Mzwakhe Wiseman Ngcobo, Deborah Mindry, Ayanda Zulu, Ntombifuthi Langa, Luyanda Maphalala, Vanessa Pillay, Maud Mthembu, Annie Miall, Whitney Tran, Ana Dillen, Fang Wan, Ali Ahmed, Jamila K Stockman, Maryam Hussain, Thumbi Ndung'u, Karine Dubé
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Abstract

Background: HIV remains a major challenge in KwaZulu-Natal, South Africa, particularly for young women who face disproportionate risks and barriers to prevention and treatment. Most HIV cure trials, however, occur in high-income countries.

Objective: To examine the perspectives of young women diagnosed with acute HIV in a longitudinal study, focusing on their perceptions on ATI-inclusive HIV cure trials and the barriers and facilitators to participation.

Materials and methods: Between October 2022 and February 2024, we conducted closed-ended surveys and in-depth interviews with 20 women aged 19-33 living with HIV, who were willing but ineligible or unable to participate in an HIV cure trial.

Results: Many participants reported mental health challenges, including major depression (40%), moderate to severe anxiety (35%), and low self-esteem (35%). While women diagnosed during acute HIV supported pausing antiretroviral treatment (ART) during analytical treatment interruption (ATI) to advance HIV cure research, concerns about health risks and HIV-related stigma were significant barriers to enrollment. Trust in the research team and close monitoring were seen as positive factors, while fears around sharing of HIV/ATI status and transmission to sex partners complicated decision-making. Participants expressed a need for psychological counseling and access to community resources to manage ATI-related stressors.

Conclusions: Understanding women's perspectives on HIV cure research, especially ATI trials, is vital. Building trust and addressing psychosocial challenges through a healing-centered approach can facilitate trial participation. Socio-behavioral research before and during HIV cure trials will be essential to inform participant-centered protocol design.

“暂停治疗是可怕的”:对艾滋病治疗相关研究的看法,以及对南非德班诊断为急性艾滋病的妇女中断治疗的分析。
背景:艾滋病毒仍然是南非夸祖鲁-纳塔尔省的一项重大挑战,特别是对年轻妇女来说,她们在预防和治疗方面面临着不成比例的风险和障碍。然而,大多数艾滋病治愈试验发生在高收入国家。目的:在一项纵向研究中,研究被诊断为急性HIV的年轻女性的观点,重点关注她们对包括ati在内的HIV治愈试验的看法,以及参与的障碍和促进因素。材料与方法:在2022年10月至2024年2月期间,我们对20名年龄在19-33岁、愿意但不符合或无法参加艾滋病治愈试验的艾滋病病毒感染者进行了封闭式调查和深度访谈。结果:许多参与者报告了心理健康挑战,包括重度抑郁(40%)、中度至重度焦虑(35%)和低自尊(35%)。虽然诊断患有急性艾滋病毒的妇女支持在分析性治疗中断(ATI)期间暂停抗逆转录病毒治疗(ART),以推进艾滋病毒治愈研究,但对健康风险和艾滋病毒相关污名的担忧是登记的重大障碍。对研究团队的信任和密切监测被视为积极因素,而对分享HIV/ATI状况和传播给性伴侣的恐惧使决策复杂化。参与者表示需要心理咨询和获得社区资源来管理与急性脑损伤相关的压力源。结论:了解妇女对艾滋病治愈研究的看法,特别是ATI试验,是至关重要的。通过以治疗为中心的方法建立信任和解决心理社会挑战可以促进试验的参与。在艾滋病治愈试验之前和期间进行社会行为研究对于为以参与者为中心的方案设计提供信息至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
15
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