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首页> 外文期刊>AIDS care. >Information, motivation, and behavioral skills for early pre-ART engagement in HIV care among patients entering clinical care in KwaZulu-Natal, South Africa
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Information, motivation, and behavioral skills for early pre-ART engagement in HIV care among patients entering clinical care in KwaZulu-Natal, South Africa

机译：在南非夸祖鲁-纳塔尔省接受临床护理的患者中，ART早期参与HIV护理之前的信息，动机和行为技能

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Little is known regarding factors implicated in early engagement and retention in HIV care among individuals not yet eligible for antiretroviral therapy (pre-ART) in sub-Saharan Africa. Identifying such factors is critical for supporting retention in pre-ART clinical care to ensure timely ART initiation and optimize long-term health outcomes. We assessed patients' pre-ART HIV care-related information, motivation, and behavioral skills among newly diagnosed ART-ineligible patients, initiating care in KwaZulu-Natal, South Africa. The survey was interviewer-administered to eligible patients, who were aged 18 years or older, newly entering care (diagnosed within the last six-months), and ineligible for ART (CD4 count 200 cells/mm3) in one of four primary care clinical sites. Self-reported information, motivation, and behavioral skills specific to retention in pre-ART HIV-care were characterized by categorizing responses into those reflecting potential strengths and those reflective of potential deficits. Information, motivation, and behavioral skills deficits sufficiently prevalent in the overall sample (i.e.,≥30% prevalent) were identified as areas in need of specific attention through intervention efforts adapted to the clinic level. Gender-based differences were also evaluated. A total of 288 patients (75% female) completed structured interviews. Across the sample, eight information, eight motivation, and eight behavioral skills deficit areas were identified as sufficiently prevalent to warrant specific targeted attention. Gender differences did not emerge. The deficits in pre-ART HIV care-related information, motivation, and behavioral skills that were identified suggest that efforts to improve accurate information on immune function and HIV disease are needed, as is accurate information regarding HIV treatment and transmission risk prior to ART initiation. Additional efforts to facilitate the development of social support, including positive interactions with clinic staff and decreasing community-level stigma and to decrease structural and resource-depleting demands of HIV care may be particularly valuable to facilitate retention in pre-ART HIV care.
机译：关于在撒哈拉以南非洲尚未获得抗逆转录病毒疗法（抗逆转录病毒治疗）的个人中，与早期参与和保留在HIV护理中有关的因素知之甚少。识别此类因素对于支持保留ART之前的临床护理至关重要，以确保及时启动ART并优化长期健康结果。我们在南非夸祖鲁-纳塔尔省（KwaZulu-Natal）进行了初次护理的患者中，评估了新诊断为不符合抗逆转录病毒疗法的患者中与患者接受抗逆转录病毒治疗有关的信息，动机和行为技能。该调查是由符合条件的患者进行访调员访问的，这些患者年龄在18岁或以上，正在接受新护理（在最近六个月内诊断出），并且在四种主要护理之一中不符合抗逆转录病毒疗法的要求（CD4计数> 200细胞/ mm3）临床部位。自我报告的信息，动机和特定于保留在抗病毒治疗之前的HIV的行为技能的特点是将响应分为反映潜在优势和反映潜在缺陷的响应。通过适应于临床水平的干预措施，在整个样本中充分普遍存在的信息，动机和行为技能缺陷（即≥30％）被确定为需要特别关注的领域。还评估了基于性别的差异。共有288位患者（75％为女性）完成了结构化访谈。在整个样本中，八个信息，八个动机和八个行为技能缺陷区域被确定为足够普遍，需要引起有针对性的关注。性别差异没有出现。已确定的抗逆转录病毒治疗前与艾滋病相关的信息，动机和行为技能的缺陷表明，需要努力改善有关免疫功能和艾滋病的准确信息，以及开始抗病毒治疗之前有关艾滋病治疗和传播风险的准确信息。为促进社会支持的发展而做出的额外努力，包括与诊所工作人员的积极互动以及减少社区层面的污名化，以及减少对艾滋病毒治疗的结构和资源消耗的需求，对于促进保留抗病毒治疗前的艾滋病毒尤其有价值。

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