{"title":"贫困与保护：多维贫困、社会保护干预措施和艾滋病毒载量之间的关系。","authors":"Amrita Ayer, Rutendo W Mukondwa, César Avilés-Guamán, Kudakwashe Takarinda, Nora West, Tatenda Makoni, Sinokuthaba Mukungwa, Waraidzo Mukuwapasi, Mollie Hudson, Canice Christian, Karen Webb, Priya B Shete","doi":"10.1097/QAD.0000000000004276","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Social protection can mitigate poverty's effects on HIV, but program implementation may influence impact. We explored relationships between multidimensional poverty, social protection programming, and HIV viral load among an adult population with HIV (PWH) in Zimbabwe.</p><p><strong>Design: </strong>A sequential explanatory mixed methods study.</p><p><strong>Methods: </strong>We analyzed retrospective cross-sectional data from client satisfaction surveys collected between January and July 2023 among adult PWH receiving care in 15 districts of Zimbabwe. We employed descriptive analyses, generalized estimated equations, and moderation analyses to evaluate relationships between multidimensional poverty, social protection, and viral load nonsuppression. Between August and September 2023, we conducted semi-structured in-depth interviews (IDIs) with adults regarding access to tuberculosis care and social protection interventions. We applied the Exploration, Preparation, Implementation, and Sustainment framework for qualitative analysis and integrated results at the interpretation phase.</p><p><strong>Results: </strong>Among 13 722 PWH [65.4% women, median age 44 years (interquartile range: 36-52)], 44.4% were multidimensionally poor. Only 18% had ever received social protection. Poverty was associated with viral load nonsuppression [adjusted prevalence ratio (aPR) = 1.55; 95% confidence interval (CI): 1.13-2.13], as was social protection receipt [aPR = 1.67; 95% CI: 1.07-2.62)]. IDIs showed that PWH experienced significant impoverishment, had little information about and access to social protection, and reported limited quantities and durations of receipt.</p><p><strong>Conclusion: </strong>We observed a high burden of poverty and tenuous access to social protection. Multidimensional poverty was associated with virologic nonsuppression, as was social protection receipt, which may signal significant vulnerability in our population and inadequacy of social protection coverage and responsiveness.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":"1926-1935"},"PeriodicalIF":3.1000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Poverty and protection: the relationship between multidimensional poverty, social protection interventions, and HIV viral load.\",\"authors\":\"Amrita Ayer, Rutendo W Mukondwa, César Avilés-Guamán, Kudakwashe Takarinda, Nora West, Tatenda Makoni, Sinokuthaba Mukungwa, Waraidzo Mukuwapasi, Mollie Hudson, Canice Christian, Karen Webb, Priya B Shete\",\"doi\":\"10.1097/QAD.0000000000004276\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Social protection can mitigate poverty's effects on HIV, but program implementation may influence impact. We explored relationships between multidimensional poverty, social protection programming, and HIV viral load among an adult population with HIV (PWH) in Zimbabwe.</p><p><strong>Design: </strong>A sequential explanatory mixed methods study.</p><p><strong>Methods: </strong>We analyzed retrospective cross-sectional data from client satisfaction surveys collected between January and July 2023 among adult PWH receiving care in 15 districts of Zimbabwe. We employed descriptive analyses, generalized estimated equations, and moderation analyses to evaluate relationships between multidimensional poverty, social protection, and viral load nonsuppression. Between August and September 2023, we conducted semi-structured in-depth interviews (IDIs) with adults regarding access to tuberculosis care and social protection interventions. We applied the Exploration, Preparation, Implementation, and Sustainment framework for qualitative analysis and integrated results at the interpretation phase.</p><p><strong>Results: </strong>Among 13 722 PWH [65.4% women, median age 44 years (interquartile range: 36-52)], 44.4% were multidimensionally poor. Only 18% had ever received social protection. Poverty was associated with viral load nonsuppression [adjusted prevalence ratio (aPR) = 1.55; 95% confidence interval (CI): 1.13-2.13], as was social protection receipt [aPR = 1.67; 95% CI: 1.07-2.62)]. IDIs showed that PWH experienced significant impoverishment, had little information about and access to social protection, and reported limited quantities and durations of receipt.</p><p><strong>Conclusion: </strong>We observed a high burden of poverty and tenuous access to social protection. Multidimensional poverty was associated with virologic nonsuppression, as was social protection receipt, which may signal significant vulnerability in our population and inadequacy of social protection coverage and responsiveness.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"1926-1935\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004276\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004276","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/12 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Poverty and protection: the relationship between multidimensional poverty, social protection interventions, and HIV viral load.
Objectives: Social protection can mitigate poverty's effects on HIV, but program implementation may influence impact. We explored relationships between multidimensional poverty, social protection programming, and HIV viral load among an adult population with HIV (PWH) in Zimbabwe.
Design: A sequential explanatory mixed methods study.
Methods: We analyzed retrospective cross-sectional data from client satisfaction surveys collected between January and July 2023 among adult PWH receiving care in 15 districts of Zimbabwe. We employed descriptive analyses, generalized estimated equations, and moderation analyses to evaluate relationships between multidimensional poverty, social protection, and viral load nonsuppression. Between August and September 2023, we conducted semi-structured in-depth interviews (IDIs) with adults regarding access to tuberculosis care and social protection interventions. We applied the Exploration, Preparation, Implementation, and Sustainment framework for qualitative analysis and integrated results at the interpretation phase.
Results: Among 13 722 PWH [65.4% women, median age 44 years (interquartile range: 36-52)], 44.4% were multidimensionally poor. Only 18% had ever received social protection. Poverty was associated with viral load nonsuppression [adjusted prevalence ratio (aPR) = 1.55; 95% confidence interval (CI): 1.13-2.13], as was social protection receipt [aPR = 1.67; 95% CI: 1.07-2.62)]. IDIs showed that PWH experienced significant impoverishment, had little information about and access to social protection, and reported limited quantities and durations of receipt.
Conclusion: We observed a high burden of poverty and tenuous access to social protection. Multidimensional poverty was associated with virologic nonsuppression, as was social protection receipt, which may signal significant vulnerability in our population and inadequacy of social protection coverage and responsiveness.
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Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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