Halkitis Perry N, Kutnick Alexandra H, Rosof Elana, Slater Simon, Parsons Jeffrey T
Department of Applied Psychology, Steinhardt School of Education, New York University, New York City, New York, USA.
J Urban Health. 2003 Mar;80(1):161-6. doi: 10.1093/jurban/jtg161.
Adherence to highly active antiretroviral therapy (HAART) regimens remains a challenge for people living with human immunodeficiency virus (HIV). Severe traumas like that of September 11, 2001, can exacerbate the difficulties already associated with adherence. A community-based sample of 68 HIV-seropositive men who have sex with men (MSM) living in New York City who were on protease inhibitor HAART regimens completed quantitative assessments to examine adherence in the aftermath of September 11th. Data were drawn from a larger study of drug use and HIV medication adherence. Assessments conducted from September 24, 2001 to October 24, 2001 were compared to assessments taken 2-4 months prior to September 11th. Repeated measures analyses of variance were used to analyze the number of missed and suboptimal doses (doses taken outside the prescribed time by +/-4 hours) reported in the 2 weeks prior to each respective assessment. The results indicated a significant increase in the number of missed doses and the number of suboptimal doses immediately after the events of September 11th. Differences in adherence were not influenced, however, by sociodemographic characteristics. These results suggest that the events of September 11th had an impact on adherence to HIV medications among MSM in New York City and provide further support for the notion that the events of September 11th may have adversely impacted the lives of seropositive individuals. Attention should be paid by clinicians working with HIV-positive individuals on how this event has been incorporated into lives of individuals already burdened by a chronic and demanding disease.
坚持高效抗逆转录病毒疗法(HAART)方案对感染人类免疫缺陷病毒(HIV)的人来说仍然是一项挑战。像2001年9月11日那样的严重创伤会加剧与坚持治疗相关的困难。对居住在纽约市、正在接受蛋白酶抑制剂HAART方案治疗的68名HIV血清阳性男男性行为者(MSM)进行了基于社区的抽样调查,完成了定量评估,以检查9月11日事件后他们的治疗依从性。数据来自一项关于药物使用和HIV药物依从性的更大规模研究。将2001年9月24日至10月24日进行的评估与9月11日前2至4个月进行的评估进行比较。采用重复测量方差分析来分析每次评估前两周报告的漏服剂量和次优剂量(在规定时间之外±4小时服用的剂量)的数量。结果表明,9月11日事件后,漏服剂量和次优剂量的数量显著增加。然而,依从性的差异不受社会人口统计学特征的影响。这些结果表明,9月11日的事件对纽约市男男性行为者的HIV药物依从性产生了影响,并进一步支持了9月11日事件可能对血清阳性个体的生活产生不利影响这一观点。治疗HIV阳性个体的临床医生应关注这一事件是如何融入到已经被一种慢性且要求苛刻的疾病所困扰的个体生活中的。