Wouters Edwin, Meulemans Herman, Van Rensburg H C J, Heunis J C, Mortelmans Dimitri
Department of Sociology and Research Centre for Longitudinal and Life Course Studies, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium.
Qual Life Res. 2007 Nov;16(9):1461-71. doi: 10.1007/s11136-007-9260-y.
In order to assess the health outcomes of the South African public sector antiretroviral treatment (ART) programme, it is important to gain a better understanding of the complex relationship between ART and the multidimensional construct quality of life (QoL). Because of the gap between supply and demand, equity issues arise concerning the provisioning of ART.
The aim of this paper is to examine how and to what extent public sector ART is related to the physical and emotional health of people living with HIV/AIDS (PLWHA).
The stratified random sample consisted of 371 AIDS patients on ART or medically certified for ART, but still awaiting treatment. A model of the relationships between patient characteristics (age and gender) and socio-economic position (educational level, income, type of dwelling, number of rooms), ART duration, and physical and emotional QoL was tested using structural equation modelling.
Patients with a higher personal income (beta = .19, P < .05) and a larger dwelling (beta = .45, P < .01) were significantly more likely to enter the programme at this early stage. The model showed that the initial months of ART have been associated with significant improvements in the physical QoL (beta = .21, P < .01). Furthermore, patients on ART reported significantly higher levels of emotional well-being than patients awaiting treatment (beta = .10, P < .01). Finally, the results indicate that ART is not only directly associated with emotional QoL, but is also indirectly associated with emotional QoL via the mediating variable physical QoL (beta = .30, P < .01).
The study suggests that the poorest of the poor are not the first beneficiaries of the public programme. Most importantly, the present findings demonstrate the positive physical and emotional health outcomes of the first 6 months of ART in the Free State, South Africa.
为了评估南非公共部门抗逆转录病毒治疗（ART）项目的健康结果，更深入地了解ART与多维生活质量（QoL）结构之间的复杂关系至关重要。由于供需差距，在ART供应方面出现了公平问题。
本文旨在研究公共部门ART如何以及在多大程度上与艾滋病毒/艾滋病感染者（PLWHA）的身心健康相关。
分层随机样本包括371名正在接受ART治疗或经医学认证适合接受ART治疗但仍在等待治疗的艾滋病患者。使用结构方程模型测试了患者特征（年龄和性别）与社会经济地位（教育水平、收入、居住类型、房间数量）、ART治疗时长以及身体和情感生活质量之间的关系模型。
个人收入较高（β = 0.19，P < 0.05）且居住面积较大（β = 0.45，P < 0.01）的患者在这一早期阶段进入该项目的可能性显著更高。该模型表明，ART治疗的最初几个月与身体生活质量的显著改善相关（β = 0.21，P < 0.01）。此外，接受ART治疗的患者报告的情感幸福感水平显著高于等待治疗的患者（β = 0.10，P < 0.01）。最后，结果表明，ART不仅与情感生活质量直接相关，还通过中介变量身体生活质量与情感生活质量间接相关（β = 0.30，P < 0.01）。
该研究表明，最贫困的人群并非公共项目的首批受益者。最重要的是，目前的研究结果证明了南非自由邦ART治疗前6个月对身体和情感健康产生的积极结果。
