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首页> 外文期刊>AIDS care. >Preparing for highly active antiretroviral therapy rollout in rural South Africa: an assessment using the information, motivation, and behavioral skills model.
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Preparing for highly active antiretroviral therapy rollout in rural South Africa: an assessment using the information, motivation, and behavioral skills model.

机译：准备在南非农村地区积极开展抗逆转录病毒疗法：使用信息，动机和行为技能模型进行的评估。

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Following a controversial history and before South Africa started the world's largest highly active antiretroviral therapy (HAART) rollout, little was known about community-level information, motivation, and behavioral skills (IMB) regarding HAART in high-HIV-prevalence rural communities. The IMB model has been shown to predict behaviors that are associated with desirable HAART outcomes. We conducted an anonymous, cross-sectional "HAART-Felt Prospects" survey among HIV-serostatus-unknown young adults in Tugela Ferry, KwaZulu-Natal. We aimed to identify behavioral aspects of HAART preparedness that could be targeted by local interventions to enhance HAART outcomes. Data analysis included: percent correct, thematic means based on a four-point Likert-scale, and composite quotients. Subjects (N=176) were Zulu (99%), young (mean 19 years), and severely impoverished (55%). Relatively high levels of information were reported: overall correct score was 46%, secondary-transmission-of-resistance information was highest (81%), and only 15% reported traditional or government-advocated folk remedies cure or treat HIV/AIDS. Motivation quotient was "consistent" with favorable HAART behaviors; attitudes toward medication-taking behaviors (3.48) and condom use during HAART (3.43) ranked the highest. Desire for HIV testing (71%) was associated with HIV treatment optimism [adjusted odds ratio (AOR)=4.0, p=0.0004] and previous experience with good treatment outcome [AOR=3.2, p=0.01]. Acceptance of HAART (93%) was associated with HIV optimism [AOR=18.0, p=0.001] and not believing government-advocated folk remedies cure or treat HIV/AIDS [AOR=10.0, p=0.04]. Behavioral skills quotient was "neutral" for favorable HAART behaviors; side effects self-efficacy was the highest (3.16); and medication-taking self-efficacy the lowest (2.51). Only 47% believed disclosing HIV-serostatus would be easy. Despite controversy surrounding HAART initiation, these results suggest that local South African at-risk youth were relatively well-poised for HAART rollout. This conclusion is supported by subsequent successful HAART rollout locally. Community-based assessments are urgently needed as HAART rollouts continue. Adaptation of this IMB-based survey may better inform efforts to enhance HAART-program implementation in resource-limited settings globally.
机译：在经历了一个有争议的历史之后，在南非开始推出世界上最大的高活性抗逆转录病毒疗法（HAART）之前，对艾滋病毒高流行农村社区中有关HAART的社区级信息，动机和行为技能（IMB）知之甚少。 IMB模型已显示出可预测与所需HAART结果相关的行为。我们在夸祖鲁-纳塔尔省的图格拉费里对未知HIV血清状况的年轻成年人进行了匿名，横断面的“ HAART感觉前景”调查。我们旨在确定HAART准备的行为方面，可以通过当地干预来提高HAART结果。数据分析包括：正确率百分比，基于四点李克特量表的主题均值和复合商。受试者（N = 176）为祖鲁族（99％），年轻（平均19岁）和严重贫困（55％）。报告的信息水平相对较高：总体正确分数为46％，抗药性二次传播信息最高（81％），只有15％的国家报告传统或政府倡导的民间疗法可治愈或治疗HIV / AIDS。动机商与良好的HAART行为“一致”。对服药行为的态度（3.48）和在HAART期间使用安全套（3.43）的态度最高。对HIV检测的渴望（71％）与HIV治疗的乐观程度[校正比值比（AOR）= 4.0，p = 0.0004]和先前的治疗效果良好[AOR = 3.2，p = 0.01]相关。接受HAART（93％）与HIV乐观[AOR = 18.0，p = 0.001]有关，并且不相信政府倡导的民间疗法可以治愈或治疗HIV / AIDS [AOR = 10.0，p = 0.04]。行为技能商对HAART的良好行为“中立”。副作用自我效能最高（3.16）;服用药物的自我效能最低（2.51）。只有47％的人认为公开HIV血清状况将很容易。尽管围绕HAART启动存在争议，但这些结果表明，南非当地的高风险青年对于HAART的推出相对有充分的准备。随后在本地成功实施HAART可以支持该结论。随着HAART的不断推出，迫切需要基于社区的评估。改编基于IMB的调查可能会更好地为增强全球在资源有限的环境中实施HAART计划的努力提供信息。

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