Journal of sexual health and AIDS research最新文献

{"title":"Challenges and Facilitators for HIV Testing Services and HIV Self-Testing Programming During Emergency Care in Kenya: A Qualitative Study of Patients.","authors":"Scarlett J Bergam, Josephine Chen, John Kinuthia, John Wamutitu Maina, Sankei Pirirei, Rose Bosire, David Bukusi, Harriet Waweru, Daniel K Ojuka, David A Katz, Carey Farquhar, Michael J Mello, Adam R Aluisio","doi":"10.63620/mkjshar.2024.1002","DOIUrl":"10.63620/mkjshar.2024.1002","url":null,"abstract":"<p><strong>Background: </strong>Young people in Sub-Saharan Africa, especially young males, have been insufficiently engaged in HIV Testing Services (HTS). In Kenya, these persons are often treated in emergency departments (EDs) for injuries, a healthcare interaction that could be leveraged for HTS including HIV self-testing (HIVST). There is however, limited data from patients on ED-HTS which impedes programmatic advancement.</p><p><strong>Methods: </strong>A qualitative study was completed to understand challenges and facilitators for ED-HTS and HIVST delivery in Kenya (12/2021-03/2022). Data were collected via 28 in-depth patient interviews (14 males, 14 females) who had been treated for injury in the Kenyatta National Hospital (KNH) ED. Transcripts were coded, summarized, and analyzed with Dedoose^™ software with both inductive and deductive codes to captured a priori and emergent themes. Data were mapped to the Capability-Opportunity-Motivation Behavioral (COM-B) model for health behavior change to identify interventions which could be used to enhanced ED-HIV services delivery.</p><p><strong>Results: </strong>Themes for challenges for ED-HTS included lack of testing, stigma, incompatibility with patient condition and lack of perceived confidentiality. Patients identified a range of facilitators for ED-HTS such as health maintenance, convenience, relevance to ED setting and trust in healthcare providers. Challenges to ED-HIVST programming included perceived testing inaccuracy, psychological impact and difficulties with follow-up. Themes on facilitators included greater privacy, supportive autonomy, time efficiency, increased accessibility and ease of testing. In mapping the data to the COM-B model, main identified themes for capability were adequate resources access and promotion of patient perceptions on testing importance. Opportunity themes identified appropriate timing for ED-HTS engagement and autonomy with HIVST use. Data themes for motivation included correct understanding of testing results, supportive patient-provider interactions, and increased agency in testing choices with varying options. These data correlated to intervention functions of education, environmental restructuring, enablement, training, modeling, incentivization an-persuasion which could be used to develop appropriate programs to promote ED-HTS delivery.</p><p><strong>Conclusion: </strong>ED patients view HTS and including HIVST as favorable. Although challenges exist, multiple pragmatic interventions can be leveraged in ED-based HIV services to enhance program development and impacts to deliver testing too difficult to reach persons already in contact with health systems.</p>","PeriodicalId":521373,"journal":{"name":"Journal of sexual health and AIDS research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}