دورية أكاديمية
"Facilitating HIV status adjustment: Qualitative insights from the Tambua Mapema proof-of-concept study in Kenya".
العنوان: | "Facilitating HIV status adjustment: Qualitative insights from the Tambua Mapema proof-of-concept study in Kenya". |
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المؤلفون: | van der Elst EM; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Abuna M; School of Public Health, Brown University, Providence, Rhode Island, United States of America., Agutu C; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Ogada F; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Galole A; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Shikuku J; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Oduor T; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya., Graham SM; Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, WA, United States of America., Sanders EJ; Department of Clinical Sciences, Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.; Centre for Tropical Medicine and Global Health, University of Oxford, Headington, United Kingdom., Operario D; School of Public Health, Brown University, Providence, Rhode Island, United States of America. |
المصدر: | PloS one [PLoS One] 2022 Jan 13; Vol. 17 (1), pp. e0261255. Date of Electronic Publication: 2022 Jan 13 (Print Publication: 2022). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: San Francisco, CA : Public Library of Science |
مواضيع طبية MeSH: | HIV Infections/*psychology, Adaptation, Psychological ; Adult ; Anti-Retroviral Agents/therapeutic use ; Female ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV-1/isolation & purification ; Humans ; Interviews as Topic ; Kenya ; Male ; Pre-Exposure Prophylaxis ; Sexual Partners/psychology ; Social Support ; Viral Load ; Young Adult |
مستخلص: | Systematic efforts are needed to prepare persons newly diagnosed with acute or chronic HIV infection to cope. We examined how patients dealt with this news, looking at how readiness to accept an HIV diagnosis impacted treatment outcomes, prevention of transmission, and HIV status disclosure. We examined vulnerability and agency over time and considered implications for policy and practice. A qualitative sub-study was embedded in the Tambua Mapema ("Discover Early") Plus (TMP) study (NCT03508908), conducted in coastal Kenya between 2017 and 2020, which was a stepped wedge trial to evaluate an opt-out HIV-1 nucleic acid testing intervention diagnosing acute and chronic HIV infections. Diagnosed participants were offered antiretroviral therapy (ART), viral load monitoring, HIV partner notification services, and provision of pre-exposure prophylaxis (PrEP) to their uninfected partners. Data were analyzed using thematic approaches. Participants included 24 individuals who completed interviews at four time points (2 weeks and 3, 6, and 9 months after diagnosis), including 18 patients (11 women and 7 men) and 6 partners (1 woman, 5 men, of whom 4 men started PrEP). Acceptance of HIV status was often a long, individualized, and complex process, whereby participants' coping strategies affected day-to-day issues and health over time. Relationship status strongly impacted coping. In some instances, couples supported each other, but in others, couples separated. Four main themes impacted participants' sense of agency: acceptance of diagnosis and commitment to ART; positive feedback after attaining viral load suppression; recognition of partner supportive role and focus on sustained healthcare support whereby religious meaning was often key to successful transition. To support patients with acute or newly diagnosed chronic HIV, healthcare and social systems must be more responsive to the needs of the individual, while also improving quality of care, strengthening continuity of care across facilities, and promoting community support. Competing Interests: The authors have declared that no competing interests exist. |
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معلومات مُعتمدة: | P30 AI027757 United States AI NIAID NIH HHS; R01 AI124968 United States AI NIAID NIH HHS; R25 MH067127 United States MH NIMH NIH HHS |
المشرفين على المادة: | 0 (Anti-Retroviral Agents) |
تواريخ الأحداث: | Date Created: 20220113 Date Completed: 20220211 Latest Revision: 20220906 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC8758194 |
DOI: | 10.1371/journal.pone.0261255 |
PMID: | 35025909 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1932-6203 |
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DOI: | 10.1371/journal.pone.0261255 |