Horne Robert, Buick Deanna, Fisher Martin, Leake Heather, Cooper Vanessa, Weinman John
Centre for Health Care Research, Post Graduate Medical School, University of Brighton, Mayfield House, Falmer, Brighton BN1 9PH, UK.
Int J STD AIDS. 2004 Jan;15(1):38-44. doi: 10.1258/095646204322637245.
This cross-sectional study assessed beliefs about highly active antiretroviral therapy (HAART) and their association with reported adherence to HAART among 109 HIV-positive patients receiving HAART while attending an ambulatory care clinic in Brighton, UK. Patients' beliefs about the necessity for and concerns about HAART and their adherence to it were assessed using validated questionnaires. There was considerable variation in beliefs and reported adherence. A quarter of participants reported low adherence to HAART and this was related to concerns about adverse effects as well as to the way in which each individual balanced concerns against perceptions of necessity. Patients were significantly more likely to report low adherence rates if their concerns were high relative to their perceptions of personal need for HAART. Patients with higher CD4 counts were significantly more likely to hold a view of HAART in which perceptions of necessity were higher relative to their concerns about adverse effects. CD4 was not related to reported adherence. A comparison of most recent viral load results between high and low adherence group identified differences in the predicted direction but these were not statistically significant. These preliminary findings suggest that patients' perceptions of HAART are important determinants of adherence with implications for future research and clinical practice.
这项横断面研究评估了109名在英国布莱顿一家门诊护理诊所接受高效抗逆转录病毒治疗（HAART）的HIV阳性患者对HAART的看法及其与报告的HAART依从性之间的关联。使用经过验证的问卷评估了患者对HAART的必要性和担忧以及他们对HAART的依从性。在看法和报告的依从性方面存在相当大的差异。四分之一的参与者报告对HAART的依从性较低，这与对不良反应的担忧以及每个人平衡担忧与对必要性的认知的方式有关。如果患者的担忧相对于他们对个人HAART需求的认知较高，他们报告低依从率的可能性显著更高。CD4计数较高的患者更有可能持有一种对HAART的看法，即相对于对不良反应的担忧，对必要性的认知更高。CD4与报告的依从性无关。高依从性组和低依从性组之间最近病毒载量结果的比较确定了预测方向上的差异，但这些差异没有统计学意义。这些初步发现表明，患者对HAART的认知是依从性的重要决定因素，对未来的研究和临床实践具有启示意义。
