失去后续治疗:尼日利亚东南部艾滋病毒/艾滋病护理的(非)社会心理障碍。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Elochukwu Ernest Uzim, Po-Han Lee
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引用次数: 0

摘要

停药仍然是尼日利亚艾滋病护理中的一个问题。尼日利亚东南部的埃努古州有 3736 名艾滋病毒/艾滋病感染者(PLHIV),其中 15-49 岁年龄段的艾滋病毒阳性率为 1.9%,高于全国同类人群 1.3%的平均水平。尽管疾病负担沉重,但该地区仍有许多病例 "失去随访"。本研究旨在通过四个患者焦点小组(共 20 名参与者)和对四家公立医院的四名临床医生的深入访谈,了解青壮年在就诊时面临的障碍。参与者是通过传单、海报和在诊所滚雪球的方式招募的;两组数据首先分别进行分析,然后再相互进行三角测量。我们发现,中断就诊的主要原因包括污名化、自杀倾向、因艾滋病毒携带者的 "新身份 "而失去谋生手段,以及贫困和营养不良。这些障碍因 COVID-19 的流行和该地区的武装冲突而变得更加复杂,使得坚持服药变得更加困难。因此,我们建议尼日利亚政府将对艾滋病毒感染者的非生物医学支持纳入以人为本的艾滋病毒护理中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lost to follow up: the (non)psychosocial barriers to HIV/AIDS care in southeast Nigeria.

Medication withdrawal remains a problem in Nigeria's HIV care. The Enugu state of southeast Nigeria has 3,736 people living with HIV/AIDS (PLHIV), with a 1.9% HIV-positive prevalence rate among the age band of 15-49 years, higher than 1.3%, the national average for the same cohort. Despite the disease burden, many cases are "lost to follow-up" in this region. Through four focus groups of patients (20 participants in total) and in-depth interviews with four clinicians from four public hospitals, this study aimed to understand the barriers to attending healthcare appointments faced by young adults. The participants were recruited through flyers, posters, and snowballs at clinics; both data sets were first analysed separately yet used to triangulate each other. We found that clinical interruptions are mainly attributable to factors such as stigma, suicidal ideation, loss of means of livelihood due to PLHIV's "new identities", and thus poverty and malnutrition. These barriers, complicated by the COVID-19 pandemic and armed conflicts in the region, have made medication adherence further challenging. Therefore, we recommend the Nigerian government integrate non-biomedical support for PLHIV into people-centred HIV care.

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