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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...

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Detalles Bibliográficos
Autores principales: Sharer, Melissa, Davis, Nicole, Makina, Ndinda, Duffy, Malia, Eagan, Sabrina
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
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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.
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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
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