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目的了解参加美沙酮维持治疗(methadone maintenance treatment,MMT)的HIV感染者抗病毒治疗影响因素及探讨扩大艾滋病抗病毒治疗(antiretroviral therapy,ART)覆盖面的对策。方法在云南和广西部分地区5个MMT门诊分别选取26名参加MMT的HIV感染者、17名参加MMT的HIV感染者家属及23名相关机构工作人员进行个人深入访谈。结果影响MMT门诊HIV感染者参加抗病毒治疗的因素主要有缺乏正确的知识、歧视和经济困难,研究对象对在MMT门诊实行直接督导下的抗病毒治疗(directly observed treatment strategy,DOTS)认同比例偏低,认为可能在保护病人隐私、对MMT门诊医生进行培训及建立相关部门之间衔接等方面存在问题。结论在美沙酮门诊开展DOTS,需要建立相关部门间工作衔接机制,完成相关工作人员培训并对目标人群及其家庭进行宣传教育和适当的关怀救助。
Objective To investigate the influential factors of antiviral therapy in HIV-infected patients who participated in methadone maintenance treatment (MMT) and to explore ways to expand the coverage of anti-retroviral therapy (ART). Methods Totally 26 HIV / AIDS patients who participated in MMT, 17 families of HIV infected persons who participated in MMT and 23 related agencies were interviewed in 5 MMT clinics in Yunnan and Guangxi. Results The main factors influencing the participation of HIV-infected patients in antiviral therapy in MMT clinics were lack of proper knowledge, discrimination and financial difficulties. The proportion of directly observed treatment strategies (DOTS) patients who underwent direct supervision at the MMT clinic was higher Low, think there may be problems in protecting the privacy of patients, training of MMT clinic doctors and establishing the connection between relevant departments. Conclusions The implementation of DOTS in methadone clinics requires the establishment of relevant inter-departmental work-engagement mechanisms, training of relevant staff, promotion and education of target groups and their families, and appropriate care and assistance.