Cargando…
Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa
Scale-up of antiretroviral therapy (ART) for people living with HIV requires differentiated models of ART delivery to improve access and contribute to achieving viral suppression for 95% of people on ART. We examined barriers and enablers in South Africa via semistructured interviews with 33 respond...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738628/ https://www.ncbi.nlm.nih.gov/pubmed/30720561 http://dx.doi.org/10.1097/JNC.0000000000000062 |
_version_ | 1783450844837969920 |
---|---|
author | Sharer, Melissa Davis, Nicole Makina, Ndinda Duffy, Malia Eagan, Sabrina |
author_facet | Sharer, Melissa Davis, Nicole Makina, Ndinda Duffy, Malia Eagan, Sabrina |
author_sort | Sharer, Melissa |
collection | PubMed |
description | Scale-up of antiretroviral therapy (ART) for people living with HIV requires differentiated models of ART delivery to improve access and contribute to achieving viral suppression for 95% of people on ART. We examined barriers and enablers in South Africa via semistructured interviews with 33 respondents (program implementers, nurses, and other health care providers) from 11 organizations. The interviews were recorded, transcribed, and analyzed for emerging themes using NVivo 11 software. Major enablers of ART delivery included model flexibility, provision of standardized guidance, and an increased focus on person-centered care. Major barriers were related to financial, human, and space resources and the need for time to allow buy-in. Stigma emerged as both a barrier and an enabler. Findings suggest that creating and strengthening models that cater to client needs can achieve better health outcomes. South Africa's efforts can inform emerging models in other settings to achieve epidemic control. |
format | Online Article Text |
id | pubmed-6738628 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-67386282019-10-02 Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa Sharer, Melissa Davis, Nicole Makina, Ndinda Duffy, Malia Eagan, Sabrina J Assoc Nurses AIDS Care Research Article Scale-up of antiretroviral therapy (ART) for people living with HIV requires differentiated models of ART delivery to improve access and contribute to achieving viral suppression for 95% of people on ART. We examined barriers and enablers in South Africa via semistructured interviews with 33 respondents (program implementers, nurses, and other health care providers) from 11 organizations. The interviews were recorded, transcribed, and analyzed for emerging themes using NVivo 11 software. Major enablers of ART delivery included model flexibility, provision of standardized guidance, and an increased focus on person-centered care. Major barriers were related to financial, human, and space resources and the need for time to allow buy-in. Stigma emerged as both a barrier and an enabler. Findings suggest that creating and strengthening models that cater to client needs can achieve better health outcomes. South Africa's efforts can inform emerging models in other settings to achieve epidemic control. Wolters Kluwer 2019 2019-08-27 /pmc/articles/PMC6738628/ /pubmed/30720561 http://dx.doi.org/10.1097/JNC.0000000000000062 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Association of Nurses in AIDS Care. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Research Article Sharer, Melissa Davis, Nicole Makina, Ndinda Duffy, Malia Eagan, Sabrina Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title | Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title_full | Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title_fullStr | Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title_full_unstemmed | Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title_short | Differentiated Antiretroviral Therapy Delivery: Implementation Barriers and Enablers in South Africa |
title_sort | differentiated antiretroviral therapy delivery: implementation barriers and enablers in south africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738628/ https://www.ncbi.nlm.nih.gov/pubmed/30720561 http://dx.doi.org/10.1097/JNC.0000000000000062 |
work_keys_str_mv | AT sharermelissa differentiatedantiretroviraltherapydeliveryimplementationbarriersandenablersinsouthafrica AT davisnicole differentiatedantiretroviraltherapydeliveryimplementationbarriersandenablersinsouthafrica AT makinandinda differentiatedantiretroviraltherapydeliveryimplementationbarriersandenablersinsouthafrica AT duffymalia differentiatedantiretroviraltherapydeliveryimplementationbarriersandenablersinsouthafrica AT eagansabrina differentiatedantiretroviraltherapydeliveryimplementationbarriersandenablersinsouthafrica |