Ellis Deborah A, Naar-King Sylvie, Cunningham Phillippe B, Secord Elizabeth
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA.
AIDS Patient Care STDS. 2006 Feb;20(2):112-21. doi: 10.1089/apc.2006.20.112.
The purpose of the current study was to evaluate a clinical program that used multisystemic therapy (MST) to improve regimen adherence and health outcomes among children with perinatally acquired HIV who exhibited high viral loads in the absence of viral resistance. MST is an intensive, home-based family therapy previously used for the treatment of serious antisocial behavior. Goals of the study were to assess the feasibility of the MST program and its effectiveness for improving health outcomes among children who were treated. The study was conducted by retrospective chart review. Ninety percent of children and families referred to the program accepted the referral and 95% received a full dose of treatment, suggesting high program feasibility. Nineteen children participated in the program. General HIV knowledge on the part of caregivers improved significantly over the course of treatment. Although caregiver-reported adherence did not change, viral loads were found to significantly decrease from referral to the end of MST treatment, with the mean change reflecting a greater than 1 log10 decrease. The majority of children maintained these improvements during the 3 months after treatment termination. Results suggest that MST holds promise as an intervention for improving health outcomes among pediatric patients with HIV.
本研究的目的是评估一个临床项目，该项目采用多系统疗法（MST）来提高围产期感染艾滋病毒且病毒载量高但无病毒耐药性的儿童的治疗方案依从性和健康结局。MST是一种强化的、基于家庭的家庭疗法，以前用于治疗严重的反社会行为。该研究的目标是评估MST项目的可行性及其对接受治疗儿童改善健康结局的有效性。该研究通过回顾性病历审查进行。转介到该项目的儿童和家庭中有90%接受了转介，95%接受了全剂量治疗，表明该项目具有很高的可行性。19名儿童参与了该项目。在治疗过程中，照顾者的一般艾滋病毒知识有了显著提高。虽然照顾者报告的依从性没有变化，但发现从转介到MST治疗结束病毒载量显著下降，平均变化反映出下降超过1个对数10。大多数儿童在治疗终止后的3个月内保持了这些改善。结果表明，MST有望作为一种干预措施来改善艾滋病毒感染儿科患者的健康结局。
