健康素养较低的HIV患者对抗逆转录病毒联合疗法的依从性
Adherence to combination antiretroviral therapies in HIV patients of low health literacy.
作者信息
Kalichman S C, Ramachandran B, Catz S
机构信息
Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53226, USA.
出版信息
J Gen Intern Med. 1999 May;14(5):267-73. doi: 10.1046/j.1525-1497.1999.00334.x.
OBJECTIVE
To test the significance of health literacy relative to other predictors of adherence to treatment for HIV and AIDS.
PARTICIPANTS
Community sample of HIV-seropositive men (n = 138) and women (n = 44) currently taking a triple-drug combination of antiretroviral therapies for HIV infection; 60% were ethnic minorities, and 73% had been diagnosed with AIDS.
MEASUREMENTS
An adapted form of the Test of Health Literacy in Adults (TOFHLA), a comprehensive health and treatment interview that included 2-day recall of treatment adherence and reasons for nonadherence, and measures of substance abuse, social support, emotional distress, and attitudes toward primary care providers.
MAIN RESULTS
Multiple logistic regression showed that education and health literacy were significant and independent predictors of 2-day treatment adherence after controlling for age, ethnicity, income, HIV symptoms, substance abuse, social support, emotional distress, and attitudes toward primary care providers. Persons of low literacy were more likely to miss treatment doses because of confusion, depression, and desire to cleanse their body than were participants with higher health literacy.
CONCLUSIONS
Interventions are needed to help persons of low literacy adhere to antiretroviral therapies.
目的
检验健康素养相对于其他预测艾滋病病毒（HIV）和艾滋病治疗依从性因素的重要性。
参与者
社区中正在接受抗逆转录病毒三联药物治疗HIV感染的HIV血清阳性男性（n = 138）和女性（n = 44）样本；60%为少数族裔，73%已被诊断为艾滋病。
测量方法
采用成人健康素养测试（TOFHLA）的改编版、一次全面的健康与治疗访谈（包括对2天治疗依从性及不依从原因的回顾），以及药物滥用、社会支持、情绪困扰和对初级保健提供者态度的测量。
主要结果
多因素逻辑回归显示，在控制了年龄、种族、收入、HIV症状、药物滥用、社会支持、情绪困扰和对初级保健提供者的态度后，教育程度和健康素养是2天治疗依从性的显著且独立的预测因素。与健康素养较高的参与者相比，低素养者更有可能因困惑、抑郁和想要净化身体而错过治疗剂量。
结论
需要采取干预措施来帮助低素养者坚持抗逆转录病毒治疗。
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