PDF(Pubmed)
Abstract：
Compared to their HIV-seropositive male counterparts, HIV-seropositive women are less likely to achieve and retain viral suppression (VS). Data regarding the social, behavioral, clinical, and structural factors that facilitate or impede viral suppression among HIV-seropositive women is needed. This study aims to examine HIV-seropositive women\'s perceptions regarding factors that contribute to their HIV treatment decisions. Two case studies describe the HIV treatment decision-making of two never suppressed, HIV-seropositive women aged 65 and 54. The framework method of analysis was employed to obtain a descriptive overview of three interrelated areas of inquiry: (1) the meanings women give to VS; (2) social, behavioral, clinical, and structural obstacles related to HIV medication adherence; and (3) women\'s perceptions of what they need to achieve and sustain (VS). The meaning of VS for both women is influenced by how they currently feel. Women\'s general feeling of wellness detracts from any sense of urgency that may be associated with engaging in HIV treatment. Mistrust of medical providers and unstable housing/unemployment pose as obstacles to medication adherence. Finally, women\'s accounts of what they need to achieve and remain virally suppressed are influenced by a gap in understanding related to HIV treatment. HIV clinicians should routinely measure their patients\' HIV health literacy to ensure patients understand when to begin and why they should continue an HIV treatment regimen. To increase their capacity to provide appropriate HIV care, providers should take into consideration how patients\' life experiences and social locations influence their HIV treatment decision-making.
摘要：
与他们的艾滋病毒血清阳性男性相比，HIV血清阳性的女性不太可能实现和保持病毒抑制（VS）。关于社会的数据，行为，临床,和结构因素，促进或阻碍艾滋病毒血清阳性妇女的病毒抑制是必要的。这项研究旨在检查HIV血清反应阳性的妇女对影响其HIV治疗决定的因素的看法。两个案例研究描述了两个从未抑制过的HIV治疗决策，65岁和54岁的艾滋病毒血清阳性妇女。采用分析的框架方法对三个相互关联的调查领域进行了描述性概述：（1）女性赋予VS的含义；（2）社会，行为，临床,以及与HIV药物依从性相关的结构性障碍；（3）妇女对她们需要实现和维持的看法（VS）。VS对两个女人的意义都受到她们目前的感受的影响。女性对健康的普遍感觉会降低任何可能与从事艾滋病毒治疗相关的紧迫感。对医疗提供者的不信任和不稳定的住房/失业构成了药物依从性的障碍。最后,女性对他们需要实现和保持病毒抑制的账户受到与艾滋病毒治疗相关的理解差距的影响。HIV临床医生应定期测量患者的HIV健康素养，以确保患者了解何时开始以及为什么应该继续进行HIV治疗方案。提高他们提供适当艾滋病毒护理的能力，提供者应考虑患者的生活经历和社会位置如何影响他们的HIV治疗决策。
