Little research has been conducted on how pre-existing indigenous community resources, especially social networks, affect the success of externally imposed HIV interventions. Antiretroviral treatment (ART), an externally initiated biomedical intervention, is being rolled out across sub-Saharan Africa. Understanding the ways in which community networks are working to facilitate optimal ART access and adherence will enable policymakers to better engage with and bolster these pre-existing resources. We conducted 67 interviews and eight focus group discussions with 127 people from three key population groups in Manicaland, eastern Zimbabwe: healthcare workers, adults on ART and carers of children on ART. We also observed over 100 h of HIV treatment sites at local clinics and hospitals. Our research sought to determine how indigenous resources were enabling people to achieve optimal ART access and adherence. We analysed data transcripts using thematic network technique, coding references to supportive community networks that enable local people to achieve ART access and adherence. People on ART or carers of children on ART in Zimbabwe report drawing support from a variety of social networks that enable them to overcome many obstacles to adherence. Key support networks include: HIV groups; food and income support networks; home-based care, church and women's groups; family networks; and relationships with healthcare providers. More attention to the community context in which HIV initiatives occur will help ensure that interventions work with and benefit from pre-existing social capital.

译文

:关于现有的土著社区资源(尤其是社会网络)如何影响外部施加的艾滋病毒干预措施的成功的研究很少。抗逆转录病毒疗法(ART)是一种外部启动的生物医学干预措施,目前正在整个撒哈拉以南非洲地区推广。了解社区网络如何促进最佳ART接入和遵守的方式,将使决策者能够更好地与这些现有资源互动并为其提供支持。我们与津巴布韦东部马尼卡兰德的三个主要人口群体的127人进行了67次访谈和八个焦点小组讨论:医疗保健工作者,接受抗逆转录病毒治疗的成年人和接受抗逆转录病毒治疗的儿童。我们还在当地诊所和医院观察了超过100小时的HIV治疗地点。我们的研究试图确定土著资源如何使人们获得最佳的抗逆转录病毒药物治疗和依从性。我们使用主题网络技术对数据记录进行了分析,对支持社区网络的引用进行了编码,使社区居民能够实现ART访问和遵守。津巴布韦接受ART治疗的人或接受ART治疗的孩子的照顾者报告说,他们获得了各种社交网络的支持,这使他们能够克服许多坚持遵守的障碍。关键的支持网络包括:艾滋病病毒感染者群体;粮食和收入支持网络;家庭护理,教会和妇女团体;家庭网络;以及与医疗保健提供者的关系。更加关注开展艾滋病行动的社区背景,将有助于确保干预措施与现有的社会资本一起工作并从中受益。

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