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Effect of participation in a randomised controlled trial of an integrated palliative care intervention on HIV-associated stigma

机译：参与随机对照试验的综合姑息治疗干预对艾滋病毒相关耻辱的影响

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We conducted in Kenya a mixed-methods randomised controlled trial (RCT) of a nurse-led palliative care intervention integrated with anti-retroviral therapy (ART) provision for the management of HIV. Here we report qualitative findings showing increased resistance to HIV-associated stigma among trial participants. A mixed method design was chosen to enable identification of the active ingredients of the intervention and exploration of participants' experiences of receiving the intervention. The RCT was conducted from July 2011 to November 2012 in a community hospital in the city of Mombasa, Kenya, with a sample of 120 adults with HIV on ART. Thirty participants were purposively selected to take part in a qualitative exit interview, based on study arm and mental health outcome. Inductive thematic analysis revealed increased resistance to HIV-associated stigma in both the intervention and control groups. Specifically, patients in both groups described benefit from the social support, compassionate care, and open and respectful communication they received through study participation. Participants described improved self-image, increased access to social agency, and increased resistance to HIV-associated stigma. Our findings suggest that there is potential to increase resistance to stigma through simple mechanisms of support, compassion, and improved communication in routine care. The self-reported impact of trial participation on stigma also has implications for future trials in populations in resource-constrained settings where stigma is common.
机译：我们在肯尼亚进行了一种混合方法随机对照试验（RCT）的护士LED姑息治疗干预，与抗逆转录病毒治疗（ART）提供了艾滋病毒的管理。在这里，我们报告了审判参与者之间显示对艾滋病毒相关耻辱的抗性增加的定性发现。选择混合方法设计，以便能够鉴定参与者接受干预的参与者的干预的活性成分。 RCT于2011年7月至2012年11月在肯尼亚市蒙巴萨市的社区医院进行，其中120名成年人艾滋病毒艺术品。三十名参与者被任意地选择参与定性出口访谈，基于研究手臂和心理健康结果。诱导专题分析显示干预和对照组中对HIV相关耻辱的抗性增加。具体而言，两组的患者描述了通过学习参与获得的社会支持，富有同情心和开放和尊重的沟通。参与者描述了改进的自我形象，增加对社会代理的访问，以及对艾滋病毒相关耻辱的增加。我们的研究结果表明，通过简单的支持，同情和改善常规护理的通信机制，可能会增加对耻辱的抵抗力。自我报告的试验参与对耻辱的影响也对资源受限环境中的群体中的未来试验有影响，其中耻辱是常见的。

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