在南非治疗中断后支持重新参与艾滋病毒服务:对无国界医生欢迎服务的混合方法方案评估
Kirsten D Arendse1, Caroline Walker1, Colin Pfaff1
1Médecins Sans Frontières, Cape Town, South Africa.
Scientific reports
|March 28, 2024
概括
欢迎服务干预通过提供以人为中心的护理,改善了艾滋病毒治疗的重新参与. 尽管医疗保健工作者态度存在挑战,但患者报告了积极的经验,并实现了高病毒载量抑制.
科学领域:
- 公共卫生 公共卫生
- 艾滋病毒/艾滋病研究研究
- 加强卫生系统 加强卫生系统
背景情况:
- 心理社会因素和卫生系统的混乱阻碍了终身抗逆转录病毒治疗的坚持.
- 卫生保健工作者 (HCW) 的态度显著影响患者参与艾滋病毒护理.
- 暂停艾滋病毒治疗需要有效的重新参与战略.
研究的目的:
- 评估欢迎服务干预措施,旨在为中断后重新接受艾滋病毒治疗的患者提供以人为本的护理.
- 评估干预对分拣,临床服务,咨询和HCW态度的影响.
- 为了改善患者保留和艾滋病毒治疗中断后的健康结果.
主要方法:
- 一项混合方法研究,将深入访谈与程序和例行健康数据分析相结合.
- 在南非Khayelitsha实施欢迎服务干预 (2020年8月至2021年2月).
- 对患者体验和HCW态度的定性评估;对临床重新参与指标和保留的定量分析.
主要成果:
- 患者报告了积极的护理体验,尽管一些HCW表现出批判的态度.
- 观察到同一天重启 (98%) 和病毒载量 (VL) 抑制 (<1000 c/mL,88%) 的高率.
- 四个月的保留率为66%,可变的临床目标实现,如CD4计数 (50%) 和结核病预防 (45%).
结论:
- 欢迎服务干预表明了以人为中心的HIV护理重新参与的潜力,从而带来了积极的患者体验和高VL抑制.
- 维持患者保留需要解决HCW态度和增强支持性行为.
- 进一步开发基于欢迎服务原则的干预措施对于长期坚持HIV治疗至关重要.
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