Your browser doesn't support javascript.
loading
How Central Ugandan HIV Clinics Adapted During COVID-19 Lockdown Restrictions to Promote Continuous Access to Care: A Qualitative Analysis.
Ware, Norma C; Wyatt, Monique A; Pisarski, Emily E; Nalumansi, Alisaati; Kasiita, Vicent; Kamusiime, Brenda; Nalukwago, Grace K; Thomas, Dorothy; Kibuuka, Joseph; Muwonge, Timothy; Mujugira, Andrew; Heffron, Renee.
Afiliação
  • Ware NC; Division of Global Health Equity, Department of Medicine, Brigham & Women's Hospital, 75 Francis St., Boston, MA, 02115, USA. norma_ware@hms.harvard.edu.
  • Wyatt MA; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA, 02115, USA. norma_ware@hms.harvard.edu.
  • Pisarski EE; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA, 02115, USA.
  • Nalumansi A; Harvard Global, Cambridge, MA, 02138, USA.
  • Kasiita V; Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Ave., Boston, MA, 02115, USA.
  • Kamusiime B; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Nalukwago GK; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Thomas D; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Kibuuka J; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Muwonge T; Department of Global Health, University of Washington, Seattle, WA, 98195, USA.
  • Mujugira A; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
  • Heffron R; Infectious Diseases Institute, Makerere University, Kampala, Uganda.
AIDS Behav ; 27(11): 3725-3734, 2023 Nov.
Article em En | MEDLINE | ID: mdl-37266823
We used qualitative data from the Partners PrEP Program (PPP) to address the question: How did Central Ugandan HIV clinics adapt to COVID-19 lockdown restrictions to promote continuous access to HIV care? PPP was a stepped-wedge cluster randomized trial of integrated PrEP and ART delivery for HIV serodifferent couples at Central Ugandan HIV clinics (NCT03586128). Individual interviews with purposefully selected PPP couples (N = 42) and clinicians, coordinators, and counselors providing HIV care (N = 36) were carried out. Sixty-four interviews were completed after lockdown and included questions about accessing and providing ART/PrEP refills during lockdown restrictions. We used an inductive, content-focused approach to analyze these interview data. Barriers to continuous access identified by interviewees included loss of income with increased cost of transport, reduced staff at clinics, and physical distancing at clinics. Interviewees pointed to multi-month refills, visits to clinics "close to home," transport to clinics for providers, and delivery of refills in neighborhoods as factors promoting continuous access to antiretroviral medications. Access barriers appeared somewhat different for ART and PrEP. Fewer resources for community delivery and pre-refill HIV testing requirements were identified as PrEP-specific access challenges. Participants emphasized their success in continuing ART/PrEP adherence during the lockdown, while providers emphasized missed refill visits. These results highlight the contributions of providers and ART/PrEP users to adaptation of HIV services during COVID-19 lockdown restrictions in Uganda. The roles of direct care providers and service users as drivers of adaptation should be recognized in future efforts to conceptualize and investigate health system resiliency.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV / Profilaxia Pré-Exposição / COVID-19 Tipo de estudo: Clinical_trials / Prognostic_studies / Qualitative_research Limite: Humans País/Região como assunto: Africa Idioma: En Revista: AIDS Behav Assunto da revista: CIENCIAS DO COMPORTAMENTO / SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Fármacos Anti-HIV / Profilaxia Pré-Exposição / COVID-19 Tipo de estudo: Clinical_trials / Prognostic_studies / Qualitative_research Limite: Humans País/Região como assunto: Africa Idioma: En Revista: AIDS Behav Assunto da revista: CIENCIAS DO COMPORTAMENTO / SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos