Morgenstern Tanya T, Grimes Deanna E, Grimes Richard M
St. Luke's Episcopal Hospital, Houston, Texas, USA.
HIV Clin Trials. 2002 Mar-Apr;3(2):168-72. doi: 10.1310/T6Y6-BRCW-AR7A-WVA3.
An important factor in adherence to antiretroviral therapy (ART) is the patient's commitment to follow the regimen, which suggests that therapy should be initiated only when the patient is ready to make such a commitment. Because there has been no research on patient readiness for ART, this study was undertaken to investigate factors that influence the decision of an HIV-positive person to seek medical care and to initiate ART.
The investigators surveyed 83 HIV-infected patients on ART. Participants completed a questionnaire that obtained information on the length of time from when they learned of their HIV-positive status to when they sought medical care, the length of time from when they learned of their HIV-positive status to when they were ready to initiate therapy, and psychological and social factors thought to be associated with readiness.
Respondents had a mean age of 37 years, 71% were male, and 65% were African American. Only 42% said they sought medical care immediately upon learning their HIV diagnosis. Fifty percent were ready to initiate therapy immediately upon learning their diagnosis, and 25% were ready within 1 year. Sixty-four percent of respondents experienced barriers that interfered with therapy initiation. Although 98% of respondents experienced at least one emotional response to HIV diagnosis, less than 25% of respondents thought that their responses interfered with readiness. However, five emotional responses demonstrated an association with readiness through chi-square analysis.
Further research is needed to explain the relationships among emotional responses to HIV diagnosis, readiness to initiate ART, and adherence.
坚持抗逆转录病毒治疗（ART）的一个重要因素是患者遵循治疗方案的意愿，这表明仅当患者准备好做出这种承诺时才应开始治疗。由于尚未有关于患者对ART准备情况的研究，因此开展本研究以调查影响HIV阳性者寻求医疗护理并开始ART治疗决策的因素。
研究人员对83名接受ART治疗的HIV感染患者进行了调查。参与者完成了一份问卷，该问卷获取了从他们得知自己HIV呈阳性状态到寻求医疗护理的时间长度、从得知自己HIV呈阳性状态到准备开始治疗的时间长度，以及被认为与准备情况相关的心理和社会因素等信息。
受访者的平均年龄为37岁，71%为男性，65%为非裔美国人。只有42%的人表示在得知自己HIV诊断后立即寻求医疗护理。50%的人在得知诊断后立即准备开始治疗，25%的人在1年内准备好。64%的受访者遇到了妨碍开始治疗的障碍。尽管98%的受访者对HIV诊断至少有过一种情绪反应，但不到25%的受访者认为他们的反应妨碍了准备情况。然而，通过卡方分析，有五种情绪反应与准备情况显示出关联。
需要进一步研究来解释对HIV诊断的情绪反应、开始ART治疗的准备情况和坚持治疗之间的关系。
