Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.

<h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Immaculate Sabelile Tenza [verfasserIn] Christine Njuguna [verfasserIn] Pumla Pamella Sodo [verfasserIn] Aviva Ruch [verfasserIn] Joel Msafiri Francis [verfasserIn] Olufemi Babatunde Omole [verfasserIn] Richard Cooke [verfasserIn] Samuel Agbo [verfasserIn] Laurel Baldwin-Ragaven [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Übergeordnetes Werk:	In: PLoS ONE - Public Library of Science (PLoS), 2007, 18(2023), 4, p e0284996
Übergeordnetes Werk:	volume:18 ; year:2023 ; number:4, p e0284996

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1371/journal.pone.0284996

Katalog-ID:	DOAJ090300815

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allfields	10.1371/journal.pone.0284996 doi (DE-627)DOAJ090300815 (DE-599)DOAJ69a40031dca0418fa073422693e418ed DE-627 ger DE-627 rakwb eng Immaculate Sabelile Tenza verfasserin aut Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa. 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Medicine R Science Q Christine Njuguna verfasserin aut Pumla Pamella Sodo verfasserin aut Aviva Ruch verfasserin aut Joel Msafiri Francis verfasserin aut Olufemi Babatunde Omole verfasserin aut Richard Cooke verfasserin aut Samuel Agbo verfasserin aut Laurel Baldwin-Ragaven verfasserin aut In PLoS ONE Public Library of Science (PLoS), 2007 18(2023), 4, p e0284996 (DE-627)523574592 (DE-600)2267670-3 19326203 nnns volume:18 year:2023 number:4, p e0284996 https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/article/69a40031dca0418fa073422693e418ed kostenfrei https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/toc/1932-6203 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_34 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_235 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 4, p e0284996
spelling	10.1371/journal.pone.0284996 doi (DE-627)DOAJ090300815 (DE-599)DOAJ69a40031dca0418fa073422693e418ed DE-627 ger DE-627 rakwb eng Immaculate Sabelile Tenza verfasserin aut Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa. 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Medicine R Science Q Christine Njuguna verfasserin aut Pumla Pamella Sodo verfasserin aut Aviva Ruch verfasserin aut Joel Msafiri Francis verfasserin aut Olufemi Babatunde Omole verfasserin aut Richard Cooke verfasserin aut Samuel Agbo verfasserin aut Laurel Baldwin-Ragaven verfasserin aut In PLoS ONE Public Library of Science (PLoS), 2007 18(2023), 4, p e0284996 (DE-627)523574592 (DE-600)2267670-3 19326203 nnns volume:18 year:2023 number:4, p e0284996 https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/article/69a40031dca0418fa073422693e418ed kostenfrei https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/toc/1932-6203 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_34 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_235 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 4, p e0284996
allfields_unstemmed	10.1371/journal.pone.0284996 doi (DE-627)DOAJ090300815 (DE-599)DOAJ69a40031dca0418fa073422693e418ed DE-627 ger DE-627 rakwb eng Immaculate Sabelile Tenza verfasserin aut Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa. 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Medicine R Science Q Christine Njuguna verfasserin aut Pumla Pamella Sodo verfasserin aut Aviva Ruch verfasserin aut Joel Msafiri Francis verfasserin aut Olufemi Babatunde Omole verfasserin aut Richard Cooke verfasserin aut Samuel Agbo verfasserin aut Laurel Baldwin-Ragaven verfasserin aut In PLoS ONE Public Library of Science (PLoS), 2007 18(2023), 4, p e0284996 (DE-627)523574592 (DE-600)2267670-3 19326203 nnns volume:18 year:2023 number:4, p e0284996 https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/article/69a40031dca0418fa073422693e418ed kostenfrei https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/toc/1932-6203 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_34 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_235 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 4, p e0284996
allfieldsGer	10.1371/journal.pone.0284996 doi (DE-627)DOAJ090300815 (DE-599)DOAJ69a40031dca0418fa073422693e418ed DE-627 ger DE-627 rakwb eng Immaculate Sabelile Tenza verfasserin aut Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa. 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Medicine R Science Q Christine Njuguna verfasserin aut Pumla Pamella Sodo verfasserin aut Aviva Ruch verfasserin aut Joel Msafiri Francis verfasserin aut Olufemi Babatunde Omole verfasserin aut Richard Cooke verfasserin aut Samuel Agbo verfasserin aut Laurel Baldwin-Ragaven verfasserin aut In PLoS ONE Public Library of Science (PLoS), 2007 18(2023), 4, p e0284996 (DE-627)523574592 (DE-600)2267670-3 19326203 nnns volume:18 year:2023 number:4, p e0284996 https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/article/69a40031dca0418fa073422693e418ed kostenfrei https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/toc/1932-6203 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_34 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_235 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 4, p e0284996
allfieldsSound	10.1371/journal.pone.0284996 doi (DE-627)DOAJ090300815 (DE-599)DOAJ69a40031dca0418fa073422693e418ed DE-627 ger DE-627 rakwb eng Immaculate Sabelile Tenza verfasserin aut Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa. 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels. Medicine R Science Q Christine Njuguna verfasserin aut Pumla Pamella Sodo verfasserin aut Aviva Ruch verfasserin aut Joel Msafiri Francis verfasserin aut Olufemi Babatunde Omole verfasserin aut Richard Cooke verfasserin aut Samuel Agbo verfasserin aut Laurel Baldwin-Ragaven verfasserin aut In PLoS ONE Public Library of Science (PLoS), 2007 18(2023), 4, p e0284996 (DE-627)523574592 (DE-600)2267670-3 19326203 nnns volume:18 year:2023 number:4, p e0284996 https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/article/69a40031dca0418fa073422693e418ed kostenfrei https://doi.org/10.1371/journal.pone.0284996 kostenfrei https://doaj.org/toc/1932-6203 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_34 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_235 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 18 2023 4, p e0284996
language	English
source	In PLoS ONE 18(2023), 4, p e0284996 volume:18 year:2023 number:4, p e0284996
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authorswithroles_txt_mv	Immaculate Sabelile Tenza @@aut@@ Christine Njuguna @@aut@@ Pumla Pamella Sodo @@aut@@ Aviva Ruch @@aut@@ Joel Msafiri Francis @@aut@@ Olufemi Babatunde Omole @@aut@@ Richard Cooke @@aut@@ Samuel Agbo @@aut@@ Laurel Baldwin-Ragaven @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
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author	Immaculate Sabelile Tenza
spellingShingle	Immaculate Sabelile Tenza misc Medicine misc R misc Science misc Q Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.
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topic_title	Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa
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title	Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.
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title_full	Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa
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author_browse	Immaculate Sabelile Tenza Christine Njuguna Pumla Pamella Sodo Aviva Ruch Joel Msafiri Francis Olufemi Babatunde Omole Richard Cooke Samuel Agbo Laurel Baldwin-Ragaven
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title_sort	exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, ekurhuleni health district, south africa
title_auth	Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.
abstract	<h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels.
abstractGer	<h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels.
abstract_unstemmed	<h4<Background</h4<Ensuring that all HIV-infected people receive antiretroviral therapy (ART) and achieve viral suppression are key South African strategies to end the AIDS epidemic in the country. National HIV treatment guidelines recommend an immediate switch to second-line ART following virological failure with first-line ART. Nurses based in district health facilities are at the forefront of implementing this recommendation. While there are often delays in switching and in some instances no switch, the reasons for and barriers to delayed switching are not well understood at the primary care level.<h4<Aim</h4<To explore the views of frontline nursing staff about factors contributing to delayed switching of patients who have failed first-line ART regimen in Ekurhuleni district, South Africa.<h4<Methods</h4<A qualitative study was conducted among 21 purposively sampled nurses who provide HIV treatment and care to patients in 12 primary health care (PHC) facilities in Ekurhuleni Health District, Gauteng Province, South Africa. Individual in-depth interviews explored nurses' experiences regarding their recognition of virological failure and understanding of "on time" switching to second-line ART. Interviews probed the circumstances contributing to delays in switching. After digital audio recording and transcription, manual inductive thematic analysis was used to analyse the data.<h4<Findings</h4<Multiple barriers were identified: 1) Healthcare provider factors included a lack of knowledge and confidence coupled with demotivation in the workplace; 2) Patient issues similarly comprised a lack of knowledge as well as resistance to being switched to another drug regimen and loss to follow up; 3) Systems factors were poor facility leadership, shortages of medication, staffing constraints, and the inability to trace laboratory results, especially for migrant patients.<h4<Conclusion</h4<Reasons for delayed switching of patients to second-line ART are multifactorial and require integrated interventions at health provider, patient and health system levels.
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title_short	Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.
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Exploring barriers to switching "on time" to second-line antiretroviral therapy among nurses in primary health care facilities, Ekurhuleni Health District, South Africa.

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