PDF(Pubmed)
Abstract：
Background: HIV is hyperendemic among fisherfolk in Sub-Saharan Africa, especially around Lake Victoria, Uganda. Purpose/Research Design: We conducted cross-sectional semi-structured interviews about oral pre-exposure prophylaxis (PrEP) implementation with 35 Ugandan fisherfolk (15 women, 20 men) and 10 key stakeholders (healthcare providers, policymakers, community leaders). We used a directed content analysis approach based on implementation science and social marketing frameworks. Results: Participants showed high acceptability for PrEP. Anticipated barriers among fisherfolk included stigma (due to similar medications/packaging as HIV treatment); misconceptions; mobility, competing needs, poverty, and partner conflict. Anticipated provider barriers included insufficient staffing and travel support. Recommendations included: change PrEP packaging; integrate PrEP with other services; decrease PrEP refill frequency; give transportation resources to providers; train more healthcare workers to provide PrEP to fisherfolk; and use positively framed messages to promote PrEP. Conclusions: Results can inform policymakers and healthcare organizations on how to overcome barriers to PrEP scale-up in most at-risk populations with poor healthcare access.
摘要：
背景：艾滋病毒在撒哈拉以南非洲的渔民中流行得很高，尤其是维多利亚湖周围,乌干达。目的/研究设计：我们对35名乌干达渔民（15名妇女，20名男性)和10名主要利益相关者(医疗保健提供者，政策制定者，社区领导人)。我们使用了基于实施科学和社会营销框架的定向内容分析方法。结果：参与者对PrEP表现出很高的可接受性。渔民之间的预期障碍包括污名（由于与艾滋病毒治疗类似的药物/包装）;误解;流动性，相互竞争的需求，贫穷,和伙伴冲突。预期的提供者障碍包括人员配备和旅行支持不足。建议包括：更改PrEP包装；将PrEP与其他服务整合；减少PrEP补充频率；向提供者提供运输资源；培训更多的医护人员向渔民提供PrEP；并使用积极的框架信息来推广PrEP。结论：结果可以为政策制定者和医疗保健组织提供有关如何克服在大多数医疗保健条件较差的风险人群中扩大PrEP的障碍。
