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首页> 美国卫生研究院文献>SAHARA J : Journal of Social Aspects of HIV/AIDS Research Alliance >Policy-maker attitudes to the ageing of the HIV cohort in Botswana
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Policy-maker attitudes to the ageing of the HIV cohort in Botswana

机译：决策者对博茨瓦纳艾滋病毒人口老龄化的态度

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Background: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana. Methods: We conducted qualitative face-to-face interviews with 15 consenting personnel from the Ministry of Health, medical practitioners and non-governmental organizations involved in the administration of medical services, planning, strategies and policies that govern social, physical and medical intervention aimed at people living with HIV and health in general. The Shiffman and Smith Framework of how health issues become a priority was used as a guide for our analysis. Results: Amidst an HIV prevalence of 25% among those aged 50–64 years, the respondents passively recognized the predicament posed by a population aging with HIV but exhibited a lack of comprehension and acknowledgement of the extent of the issue. An underlying persistent ageist stigma regarding sexual behaviour existed among a number of interviewees. Respondents also noted the lack of defined geriatric care within the provision of the national health care system. There seemed, however, to be a debate among the policy strategists and care providers as to whether the appropriate response should be specifically towards older adults living with HIV or rather to improve health services for older adults more generally. Respondents acknowledged that health systems in Botswana are still configured for individual diseases rather than coexisting chronic diseases even though it has become increasingly common for patients, particularly the aged, to have two or more medical conditions at the same time. Conclusions: HIV among older adults remains a low priority among policy-makers in Botswana but is at least now on the agenda. Action will require more concerted efforts to recognize HIV as a lifelong infection and putting greater emphasis on targeted care for older adults, focussing on multimorbidity.
机译：背景：博茨瓦纳的抗逆转录病毒疗法的推广，就像许多几乎可以普遍获得治疗的国家一样，已经使艾滋病毒转变为复杂但可控制的慢性病，​​并导致了艾滋病毒人口老龄化的出现。尽管已经在国际上实现了这一发展，但在许多受影响最严重的国家，尚未建立明确的干预策略。因此，我们探讨了博茨瓦纳老年人（50岁或以上）中决策者和服务提供者对艾滋病毒的态度。方法：我们与来自卫生部的15名同意人员，从事医疗服务管理的执业医生和非政府组织进行了定性的面对面访谈，并制定了旨在管理社会，身体和医学干预措施的规划，策略和政策艾滋病毒感染者和一般健康人群。关于健康问题如何成为优先事项的Shiffman and Smith框架被用作我们分析的指南。结果：在50-64岁的人群中，艾滋病毒的患病率为25％，受访者被动地认识到艾滋病毒人口老龄化所带来的困境，但对问题的严重程度缺乏理解和认识。在许多受访者中，存在着关于性行为的潜在的持久性年龄歧视。受访者还指出，在国家卫生保健系统的规定范围内缺乏明确的老年医学护理。但是，政策策略师和护理提供者之间似乎存在争议，即适当的应对措施应该专门针对感染艾滋病毒的老年人，还是更广泛地改善对老年人的医疗服务。受访者承认，博茨瓦纳的卫生系统仍然针对个别疾病而不是并存的慢性病，​​尽管对于病人（尤其是老年人）同时具有两种或两种以上的医疗条件已经变得越来越普遍。结论：博茨瓦纳的决策者在老年人中仍然没有把艾滋病毒作为优先事项，但至少现在已经提上了议程。采取行动将需要更多的共同努力，以将艾滋病毒识别为终身感染，并更加重视针对老年人的针对性护理，重点是多发病。

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