Food Insecurity as a Barrier to Sustained Antiretroviral Therapy Adherence in Uganda 英文参考文献.docVIP

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Food Insecurity as a Barrier to Sustained Antiretroviral Therapy Adherence in Uganda 英文参考文献.doc

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Food Insecurity as a Barrier to Sustained Antiretroviral Therapy Adherence in Uganda 英文参考文献

FoodInsecurityasaBarriertoSustainedAntiretroviral TherapyAdherenceinUganda SheriD.Weiser1,2*.,DavidM.Tuller3.,EdwardA.Frongillo4,JudeSenkungu5,NozmuMukiibi5,DavidR. Bangsberg5,6,7,8 1DivisionofHIV/AIDS,SanFranciscoGeneralHospital,SanFrancisco,California,UnitedStatesofAmerica,2CenterforAIDSPreventionStudies,UniversityofCalifornia San Francisco, San Francisco, California, United States of America, 3School of Public Health, University of California, Berkeley, California, United States of America, 4Department ofHealthPromotion,Education,andBehavior,ArnoldSchoolofPublicHealth,UniversityofSouthCarolina,Columbia,SouthCarolina,UnitedStatesof America,5MbararaUniversityofScienceandTechnology,Mbarara,Uganda,6RagonInstituteofMassachusettsGeneralHospital,MassachusettsInstituteofTechnology and Harvard, Boston, Massachusetts, United States of America, 7Massachusetts General Hospital Center for Global Health, Harvard Medical School, Cambridge, Massachusetts,UnitedStatesofAmerica,8HarvardInitiativeforGlobalHealth,Boston,Massachusetts,UnitedStatesofAmerica Abstract Background: Foodinsecurityisemergingasanimportantbarriertoantiretroviral(ARV)adherenceinsub-SaharanAfrica andelsewhere,butlittleisknownaboutthemechanismsthroughwhichfoodinsecurityleadstoARVnon-adherenceand treatmentinterruptions. Methodology: We conductedin-depth, open-ended interviews with47 individuals (30women,17 men) living withHIV/ AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interfereswithARV therapyregimens. Interviews weretranscribed, codedforkeythemes,andanalyzed usinggrounded theory. Findings: Food insecurity was common and an important barrier to accessing medical care and ARV adherence. Five mechanisms emerged for how food insecurity can contribute to ARV non-adherence and treatment interruptions or to postponingARVinitiation:1)ARVsincreasedappetiteandledtointolerablehungerintheabsenceoffood;2)Sideeffectsof ARVswereexacerbatedintheabsenceoffoo