Reback C J, Larkins S, Shoptaw S
Friends Research Institute, Los Angeles, CA 90025, USA.
AIDS Care. 2003 Dec;15(6):775-85. doi: 10.1080/09540120310001618621.
Medication adherence among persons with HIV infection is important not only because of the effect of non-adherence on an individual's health but also because non-adherence can lead to medication-resistant viral strains. However, adherence to HIV medications is difficult due to complex dosing regimens and side effects. This paper is a qualitative analysis of HIV medication adherence among gay and bisexual methamphetamine-abusing men enrolled in an outpatient drug treatment research project. As part of an open-ended, semi-structured interview, 23 HIV-infected men discussed the effects of their methamphetamine use on their medication adherence. Substance-use barriers to adherence were coded into two main themes: (1) planned non-adherence and (2) unplanned non-adherence. Planned non-adherence was a strategy for coping with demanding HIV medication schedules, or was linked to sexual behaviours while using methamphetamine or to fears of interaction effects from mixing methamphetamine with HIV medications. Participants did not define their medication regimen adjustments as non-adherence but as a way to achieve a sense of control over their lives. Unplanned non-adherence was linked to methamphetamine-related disruptions in food and sleep schedules. Findings are helpful in designing culturally specific HIV medication adherence interventions for this population.
对于感染艾滋病毒的人来说，坚持服药很重要，这不仅是因为不服药会影响个人健康，还因为不服药会导致产生抗药病毒株。然而，由于服药方案复杂且有副作用，坚持服用艾滋病毒药物很困难。本文是对参与门诊药物治疗研究项目的男同性恋和双性恋甲基苯丙胺滥用者的艾滋病毒药物依从性进行的定性分析。作为开放式半结构化访谈的一部分，23名感染艾滋病毒的男性讨论了他们使用甲基苯丙胺对其药物依从性的影响。依从性的物质使用障碍被归纳为两个主要主题：（1）计划性不依从和（2）非计划性不依从。计划性不依从是应对严格的艾滋病毒服药时间表的一种策略，或者与使用甲基苯丙胺时的性行为有关，或者与担心甲基苯丙胺与艾滋病毒药物混合产生相互作用有关。参与者并未将他们对服药方案的调整定义为不依从，而是将其视为一种掌控自己生活的方式。非计划性不依从与甲基苯丙胺导致的饮食和睡眠时间表紊乱有关。研究结果有助于为这一人群设计具有文化针对性的艾滋病毒药物依从性干预措施。
