دورية أكاديمية
Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya.
العنوان: | Health Provider Views on Improving Antiretroviral Therapy Adherence Among Men Who Have Sex with Men in Coastal Kenya. |
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المؤلفون: | Micheni M; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya ., Kombo BK; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya ., Secor A; 2 Innovations for Poverty Action , Lusaka, Zambia ., Simoni JM; 3 Department of Psychology and Global Health, University of Washington , Seattle, Washington., Operario D; 4 Department of Behavioral and Social Sciences, School of Public Health, Brown University , Providence, Rhode Island., van der Elst EM; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya ., Mugo P; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya ., Kanungi J; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya ., Sanders EJ; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya .; 5 Nuffield Department of Medicine, University of Oxford , Oxford, United Kingdom ., Graham SM; 1 Centre for Geographic Medicine and Research, Coast, Kenya Medical Research Institute , Kilifi, Kenya .; 6 Departments of Medicine, Global Health, and Epidemiology, University of Washington , Seattle, Washington. |
المصدر: | AIDS patient care and STDs [AIDS Patient Care STDS] 2017 Mar; Vol. 31 (3), pp. 113-121. Date of Electronic Publication: 2017 Feb 22. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 9607225 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-7449 (Electronic) Linking ISSN: 10872914 NLM ISO Abbreviation: AIDS Patient Care STDS Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Larchmont, NY : Mary Ann Liebert, Inc., c1996- |
مواضيع طبية MeSH: | Homosexuality, Male*/ethnology , Homosexuality, Male*/psychology , Medication Adherence* , Social Stigma*, HIV Infections/*drug therapy , Health Personnel/*psychology , Health Services/*statistics & numerical data, Adolescent ; Adult ; Attitude of Health Personnel ; Female ; Focus Groups ; HIV Infections/psychology ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Humans ; Interviews as Topic ; Kenya ; Male ; Middle Aged ; Motivation ; Patient Acceptance of Health Care ; Peer Group ; Qualitative Research ; Stereotyping ; Truth Disclosure ; Young Adult |
مستخلص: | HIV-positive Kenyan men who have sex with men (MSM) are a highly stigmatized group facing barriers to care engagement and antiretroviral therapy (ART) adherence. Because care providers' views are important in improving outcomes, we sought the perspective of those serving MSM patients on how to optimize ART adherence in a setting where same-sex behavior is criminalized. We conducted 4 focus group discussions with a total of 29 healthcare workers (HCWs) experienced in providing HIV care to MSM. The semistructured, open-ended topic guide used was based on an access-information-motivation-proximal cues model of adherence, with added focus on trust in providers, stigma, and discrimination. Detailed facilitator notes and transcripts were translated into English and reviewed for common themes. The HCW identified adherence challenges of MSM patients that are similar to those of the general population, including HIV-related stigma and lack of disclosure. In addition, HCWs noted challenges specific to MSM, such as lack of access to MSM-friendly health services, economic and social challenges due to stigma, difficult relationships with care providers, and discrimination at the clinic and in the community. HCWs recommended clinic staff sensitivity training, use of trained MSM peer navigators, and stigma reduction in the community as interventions that might improve adherence and health outcomes for MSM. Despite noting MSM-specific barriers, HCWs recommended strategies for improving HIV care for MSM in rights-constrained settings that merit future research attention. Most likely, multilevel interventions incorporating both individual and structural factors will be necessary. |
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معلومات مُعتمدة: | R34 MH099946 United States MH NIMH NIH HHS |
فهرسة مساهمة: | Keywords: HIV-AIDS; Kenya; adherence; antiretroviral therapy; healthcare providers; men who have sex with men |
تواريخ الأحداث: | Date Created: 20170311 Date Completed: 20170605 Latest Revision: 20181202 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC5359680 |
DOI: | 10.1089/apc.2016.0213 |
PMID: | 28282249 |
قاعدة البيانات: | MEDLINE |
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