tailieunhanh - báo cáo hóa học:" Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia: a cross-sectional study of cost, stigma, and perceptions about ART"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học đề tài : Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia: a cross-sectional study of cost, stigma, and perceptions about ART | Fox et al. Journal of the International AIDS Society 2010 13 8 http content 13 1 8 JOURNALOF THE INTERNATIONAL AIDS SOCIETY RESEARCH Open Access Barriers to initiation of antiretroviral treatment in rural and urban areas of Zambia a cross-sectional study of cost stigma and perceptions about ART Matthew P Fox1 Arthur Mazimba2 Phil Seidenberg1 2 Denise Crooks3 Bornwell Sikateyo4 Sydney Rosen1 Abstract Background While the number of HIV-positive patients on antiretroviral therapy ART in resource-limited settings has increased dramatically some patients eligible for treatment do not initiate ART even when it is available to them. Understanding why patients opt out of care or are unable to opt in is important to achieving the goal of universal access. Methods We conducted a cross-sectional survey among 400 patients on ART those who were able to access care and 400 patients accessing home-based care HBC but who had not initiated ART either they were not able to or chose not to access care in two rural and two urban sites in Zambia to identify barriers to and facilitators of ART uptake. Results HBC patients were 50 more likely to report that it would be very difficult to get to the ART clinic than those on ART RR 95 CI . Stigma was common in all areas with 54 of HBC patients but only 15 of ART patients being afraid to go to the clinic RR 95 CI . Cost barriers differed by location urban HBC patients were three times more likely to report needing to pay to travel to the clinic than those on ART RR 95 CI and 10 times more likely to believe they would need to pay a fee at the clinic RR 95 CI . In rural areas HBC subjects were more likely to report needing to pay non-transport costs to attend the clinic than those on ART RR 95 CI . HBC patients were twice as likely as ART patients to report not having enough food to take ART being a concern 27 vs. 13 RR 95 CI regardless