Mediating antiretroviral treatment for HIV during COVID-19: lessons from implementation in Gomba District, Uganda.

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Kenneth Mulondo, Warren Parker
{"title":"Mediating antiretroviral treatment for HIV during COVID-19: lessons from implementation in Gomba District, Uganda.","authors":"Kenneth Mulondo,&nbsp;Warren Parker","doi":"10.2989/16085906.2022.2103006","DOIUrl":null,"url":null,"abstract":"<p><p>Initial and subsequent waves of COVID-19 in Uganda disrupted the delivery of HIV care. In rural areas, village health teams and organisations on the ground had to develop strategies to ensure that people living with HIV could continue their treatment. It was necessary to take evolving circumstances into account, including dealing with movement restrictions, constrained access to food and stigma due to anonymity being lost as a result of a shift from health facility-based services to community-level support. Uganda has a long history of community-driven response to HIV, although health systems and response programming have become more centralised through government and donors to address political commitments to HIV treatment and other targets. The delivery system for antiretroviral therapy was vulnerable to the impacts of COVID-19 restrictions and related circumstances. To understand the continuum of challenges, and to inform ongoing and future support of treatment for people living with HIV, interviews were conducted with HIV organisation implementers, health workers, village health team members and people living with HIV. It was found that stigma was a central challenge, which led to nuanced adaptations for delivering antiretroviral treatment. There is a need to strengthen support to households of people living with HIV through improving community capacity to manage crises through improving household food gardens and savings, as well as capacity to organise and interact with support systems such as the village health teams. In communities, there is a need to evoke dialogue on stigma and to support community leadership on pressing issues that affect communities as a whole and their vulnerable groups. There are opportunities to reawaken the grassroots civic response systems that were evident in Uganda's early response to HIV yet were lacking in the COVID-19 context.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ajar-African Journal of Aids Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2989/16085906.2022.2103006","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Initial and subsequent waves of COVID-19 in Uganda disrupted the delivery of HIV care. In rural areas, village health teams and organisations on the ground had to develop strategies to ensure that people living with HIV could continue their treatment. It was necessary to take evolving circumstances into account, including dealing with movement restrictions, constrained access to food and stigma due to anonymity being lost as a result of a shift from health facility-based services to community-level support. Uganda has a long history of community-driven response to HIV, although health systems and response programming have become more centralised through government and donors to address political commitments to HIV treatment and other targets. The delivery system for antiretroviral therapy was vulnerable to the impacts of COVID-19 restrictions and related circumstances. To understand the continuum of challenges, and to inform ongoing and future support of treatment for people living with HIV, interviews were conducted with HIV organisation implementers, health workers, village health team members and people living with HIV. It was found that stigma was a central challenge, which led to nuanced adaptations for delivering antiretroviral treatment. There is a need to strengthen support to households of people living with HIV through improving community capacity to manage crises through improving household food gardens and savings, as well as capacity to organise and interact with support systems such as the village health teams. In communities, there is a need to evoke dialogue on stigma and to support community leadership on pressing issues that affect communities as a whole and their vulnerable groups. There are opportunities to reawaken the grassroots civic response systems that were evident in Uganda's early response to HIV yet were lacking in the COVID-19 context.

2019冠状病毒病期间调解艾滋病毒抗逆转录病毒治疗:乌干达贡巴区实施的经验教训
在乌干达,最初和随后的COVID-19浪潮扰乱了艾滋病毒护理的提供。在农村地区,当地的村卫生队和组织必须制定战略,以确保艾滋病毒感染者能够继续接受治疗。有必要考虑到不断变化的情况,包括处理行动限制、获得食物的机会受限以及由于从保健设施的服务转向社区一级的支助而失去匿名性所造成的耻辱。乌干达在社区驱动的艾滋病毒应对方面有着悠久的历史,尽管卫生系统和应对规划已经通过政府和捐助者变得更加集中,以实现对艾滋病毒治疗和其他目标的政治承诺。抗逆转录病毒治疗的提供系统很容易受到COVID-19限制和相关情况的影响。为了了解挑战的连续性,并告知目前和未来对艾滋病毒感染者治疗的支持,对艾滋病毒组织的执行者、卫生工作者、村卫生工作队成员和艾滋病毒感染者进行了访谈。人们发现,污名化是一个核心挑战,这导致了提供抗逆转录病毒治疗的细微调整。有必要加强对艾滋病毒感染者家庭的支持,办法是改善社区管理危机的能力,改善家庭菜园和储蓄,以及组织支助系统(如村卫生队)并与之互动的能力。在社区,有必要就污名化问题开展对话,并在影响整个社区及其弱势群体的紧迫问题上支持社区领导。我们有机会重新唤醒基层公民应对系统,这些系统在乌干达早期应对艾滋病毒的行动中很明显,但在2019冠状病毒病的背景下却缺乏。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Ajar-African Journal of Aids Research
Ajar-African Journal of Aids Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.80
自引率
8.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信