Nationwide rollout of antiretroviral treatment (ART) is increasing the number of older persons living with HIV (OPLWH) in South Africa. Yet, little is known about how the sociological aspects of ageing – stigma, finances and family dynamics – impact access to ART. Qualitative interviews with 23 persons aged 50-plus living near Cape Town highlight the barriers and facilitators to the acceptability, affordability and availability of ART access among OPLWH. Key age-related barriers included perceived shame of sexuality and disclosing HIV status to others, perceived disrespect by clinical staff, affording transportation to clinics and pre-existing co-morbidities. Key age-related facilitators included family moral and financial support, particularly from children and grandchildren, and access to social grants. Importantly, many barriers and facilitators had feedback loops, for example social grants reduced transportation barriers to clinics when ageing and poor health limited mobility. As the population living with HIV ages, it is critical to assess the ways ageing, as a social process, impacts ART access and to address these to improve older persons’ HIV care.

中文翻译：

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“你必须忍受，因为你是为了你来的目的”：南非艾滋病毒感染者获得抗逆转录病毒治疗的障碍和促进因素

抗逆转录病毒治疗 (ART) 的全国推广正在增加南非感染艾滋病毒的老年人 (OPLWH) 的数量。然而，人们对老龄化的社会学方面——耻辱感、财务状况和家庭动态——如何影响获得 ART 的影响知之甚少。对居住在开普敦附近的 23 名 50 岁以上的人进行的定性访谈突出了在可接受性、可负担性和可用性方面的障碍和促进因素OPLWH 之间的 ART 访问。与年龄相关的主要障碍包括对性行为感到羞耻和向他人透露 HIV 感染状况、临床工作人员认为不尊重、提供前往诊所的交通费用和先前存在的合并症。与年龄相关的关键促进因素包括家庭的道德和经济支持，特别是来自子女和孙辈的支持，以及获得社会补助金的机会。重要的是，许多障碍和促进者都有反馈回路，例如，当老龄化和健康状况不佳限制行动能力时，社会补助金减少了前往诊所的交通障碍。随着 HIV 感染者的老龄化，评估老龄化作为一个社会过程对 ART 获取的影响方式并解决这些问题以改善老年人的 HIV 护理至关重要。