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Tytuł pozycji:

Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia.

Tytuł:
Identifying barriers to ART initiation and adherence: An exploratory qualitative study on PMTCT in Zambia.
Autorzy:
Kanguya T; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Koyuncu A; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Sharma A; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Kusanathan T; Department of Gender Studies, University of Zambia, Lusaka, Zambia.
Mubanga M; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Chi BH; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
Vinikoor MJ; University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
Mubiana-Mbewe M; Centre for Infectious Diseases Research in Zambia, Lusaka, Zambia.
Źródło:
PloS one [PLoS One] 2022 Jan 13; Vol. 17 (1), pp. e0262392. Date of Electronic Publication: 2022 Jan 13 (Print Publication: 2022).
Typ publikacji:
Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
Język:
English
Imprint Name(s):
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms:
Antiretroviral Therapy, Highly Active/*psychology
Medication Adherence/*psychology
Patient Compliance/*psychology
Adult ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active/methods ; Antiretroviral Therapy, Highly Active/trends ; Female ; Focus Groups ; HIV Infections/drug therapy ; Humans ; Infectious Disease Transmission, Vertical ; Male ; Medication Adherence/statistics & numerical data ; Patient Compliance/statistics & numerical data ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy ; Pregnant Women ; Qualitative Research ; Sexual Partners ; Zambia/epidemiology
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Substance Nomenclature:
0 (Anti-HIV Agents)
Entry Date(s):
Date Created: 20220113 Date Completed: 20220218 Latest Revision: 20220218
Update Code:
20240104
PubMed Central ID:
PMC8757984
DOI:
10.1371/journal.pone.0262392
PMID:
35025923
Czasopismo naukowe
Background: Though antiretroviral therapy (ART) is widely available, HIV positive pregnant women in Zambia are less likely to start and remain on therapy throughout pregnancy and after delivery. This study sought to understand readiness to start ART among HIV pregnant women from the perspectives of both women and men in order to suggest more holistic programs to support women to continue life-long ART after delivery.
Methods: We conducted a qualitative study with HIV positive pregnant women before and after ART initiation, and men with female partners, to understand readiness to start lifelong ART. We conducted 28 in-depth interviews among women and 2 focus group discussions among male partners. Data were transcribed verbatim and analyzed in NVivo 12 using thematic analysis. Emerging themes from the data were organized using the social ecological framework.
Results: Men thought of their female partners as young and needing their supervision to initiate and stay on ART. Women agreed that disclosure and partner support were necessary preconditions to ART initiation and adherence and, expressed fear of divorce as a prominent barrier to disclosure. Maternal love and desire to look after one's children instilled a sense of responsibility among women which motivated them to overcome individual, interpersonal and health system level barriers to initiation and adherence. Women preferred adherence strategies that were discrete, the effectiveness of which, depended on women's intrinsic motivation.
Conclusion: The results support current policies in Zambia to encourage male engagement in ART care. To appeal to male partners, messaging on ART should be centered on emphasizing the importance of male involvement to ensure women remain engaged in ART care. Programs aimed at supporting postpartum ART adherence should design messages that appeal to both men's role in couples' joint decision-making and women's maternal love as motivators for adherence.
Competing Interests: The authors have declared that no competing interests exist.
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