S1 Data -

Background
Decreasing or flattening funding for vertical HIV services means that new and innovative ways of providing care are necessary. This study aimed to assess the determinants of readiness for integration of Antiretroviral Therapy (ART) services at the departmental level among primary health care providers (PHCP) at selected health facilities in Lira District.
Methods
A cross-sectional survey employing mixed methods approaches was conducted between January and February 2022 among 340 primary healthcare practitioners (PHCP) at selected health facilities in Lira district. An interviewer-administered questionnaire was used to collect quantitative data. Quantitative data was analyzed using Stata version 15. and presented as proportions, means, percentages, frequencies, and odds ratios. Logistic regression was used to determine associations of the factors with readiness for ART integration at a 95% level of significance. Thematic analysis was used to analyze qualitative data.
Results
The majority 75.2% (95% CI; 0.703–0.795) of the respondents reported being ready for the integration of ART services. PHCPs who were aware of the integration of services and those who had worked in the same facility for at least 6 years had higher odds of readiness for integration of ART, compared with their counterparts [aOR = 7.36; 95% CI = 3.857–14.028, p-value <0.001] for knowledge and duration at the current facility [aOR = 2.92; 95% CI = 1.293–6.599, p-value < 0.05] respectively. From the qualitative data, the dominant view was that integration is a good thing that should be implemented immediately. However, several challenges were noted, key among which include limited staffing and drug supplies at the facilities, coupled with limited space.
Conclusions
The study reveals a high level of readiness for the integration of ART services at departmental levels among Primary Healthcare Providers. Notably, PHCPs knowledgeable about integration and those who spent at least six years at the current health facility of work, were strong determinants for the integration of ART services in resource limited settings. In light of these findings, we recommend that policymakers prioritize the implementation of training programs aimed at upskilling healthcare workers. Furthermore, we advocate that a cluster randomized controlled trial be conducted, to evaluate the long-term effects of this integration on overall health outcomes.

背景
针对垂直型艾滋病防治服务的资助持续缩减或趋于平稳，亟需探索创新照护供给新模式。本研究旨在评估利拉区选定医疗机构的初级卫生保健提供者（Primary Health Care Providers, PHCP）在部门层面开展抗逆转录病毒治疗（Antiretroviral Therapy, ART）服务整合准备就绪情况的影响因素。

方法
本研究于2022年1-2月采用混合方法研究设计，在利拉区选定医疗机构的340名初级卫生保健从业者中开展横断面调查。通过访谈者施测的问卷收集定量数据，采用Stata 15统计软件进行数据分析，以构成比、均数、百分比、频数及比值比呈现研究结果；以逻辑回归在95%显著性水平下分析各因素与ART服务整合准备就绪情况的关联；采用主题分析法对定性数据进行分析。

结果
75.2%（95%置信区间：0.703–0.795）的受访者表示已做好ART服务整合的准备工作。相较于对照组，知晓服务整合相关知识的初级卫生保健提供者、在当前机构任职至少6年的从业者，其ART服务整合准备就绪的校正后比值比（adjusted odds ratio, aOR）更高：其中知识水平对应的aOR为7.36，95%CI=3.857–14.028，p值<0.001；当前机构工作时长对应的aOR为2.92，95%CI=1.293–6.599，p值<0.05。定性数据的主流观点认为，服务整合是一项应尽快落地的利好举措，但同时也存在多项现实挑战，核心问题包括机构人员与药物供给不足、场地空间有限。

结论
本研究显示，初级卫生保健提供者在部门层面的ART服务整合准备就绪程度较高。值得注意的是，知晓服务整合知识的从业者及在当前机构任职满6年的人员，是资源受限环境下ART服务整合的关键影响因素。基于上述研究结果，我们建议政策制定者优先开展针对医护人员的技能提升培训项目。此外，我们倡导开展整群随机对照试验，以评估该服务整合模式对整体健康结局的长期影响。