在印度尼西亚,恐惧对开始抗逆转录病毒疗法所起的阻碍和促进作用:来自患者和提供者的见解。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Bona S H Hutahaean, Sarah E Stutterheim, Kai J Jonas
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引用次数: 0

摘要

在印度尼西亚,启动抗逆转录病毒疗法(ART)是一项重大挑战,有关启动抗逆转录病毒疗法的具体障碍和促进因素的研究十分有限。我们采用社会生态学方法,通过半结构式访谈,探讨了 67 名参与者的观点:其中包括 17 名尚未接受抗逆转录病毒疗法治疗的艾滋病病毒感染者、30 名正在接受治疗的艾滋病病毒感染者和 20 名艾滋病服务提供者(HSPs)。恐惧是开始治疗的普遍障碍,在个人层面上,包括对负面医疗和非医疗后果的(非理性)恐惧。在卫生系统层面,恐惧与对官僚主义和全民覆盖不足的担忧有关。在社会层面,恐惧源于流行的神话、社交媒体上的错误信息以及 COVID-19 的影响。有趣的是,恐惧也是启动的促进因素。在人际层面上,担心健康状况恶化或因艾滋病相关病症而死亡是促成艾滋病感染的原因。在人际交往层面,好友和 HSP 起到了促进主动感染的作用。在社会层面上,社交媒体上准确但又诱发恐惧的信息刺激了人们开始接触艾滋病。艾滋病病毒感染者和艾滋病毒感染者的观点有所不同,艾滋病病毒感染者强调个人内部和卫生系统层面的障碍,而艾滋病毒感染者则主要关注个人内部和人际层面的障碍,尽管他们也认识到卫生系统的关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of fear as a barrier and facilitator to antiretroviral therapy initiation in Indonesia: insights from patients and providers.

Initiating antiretroviral therapy (ART) in Indonesia poses major challenges, with limited studies on specific ART initiation barriers and facilitators. Using a socioecological approach, we explored, through semi-structured interviews, the perspectives of 67 participants: 17 people with HIV not (yet) on ART, 30 people with HIV on treatment, and 20 HIV service providers (HSPs). Fears emerged as pervasive barriers to initiation encompassing, at the intrapersonal level, (irrational) fears of negative medical and non-medical consequences. At the health system level, fears were linked to concerns about bureaucracy and insufficient universal coverage. On a societal level, fears stemmed from prevalent myths, misinformation on social media, and the impact of COVID-19. Interestingly, fear also served as a facilitator to initiation. At the intrapersonal level, initiation was driven by a fear of deteriorating health or death due to AIDS-related conditions. At the interpersonal level, buddies and HSPs leveraged to motivate initiation. At the societal level, accurate yet fear-inducing information on social media stimulated initiation. Perspectives differed between people with HIV and HSP, with people with HIV emphasizing barriers on intrapersonal to health system levels, while HSP focused mostly on intrapersonal and interpersonal barriers, albeit recognizing the crucial role of health systems.

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CiteScore
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