Birbeck Gretchen L, Chomba Elwyn, Kvalsund Michelle, Bradbury Richard, Mang'ombe Charles, Malama Kennedy, Kaile Trevor, Byers Peter A, Organek Natalie
Michigan State University, East Lansing, USA.
Am J Trop Med Hyg. 2009 Apr;80(4):669-74.
We conducted a retrospective chart review of antiretroviral therapy (ART) clinic patients treated during the first 12 months after clinics opened in rural Zambia and assessed adherence based on clinic attendance, patient report, and staff assessment. We identified 255 eligible patients (mean age, 39.7 years; 44.3% male; 56.5% married; and 45.5% with only primary school education). Twenty percent had partners known to be HIV positive. Twenty percent were widowed. Thirty-seven percent had disclosed their HIV status to their spouse. Disclosure was less likely among women (27.5% versus 49.6%, P = 0.0005); 36.5% had "clinic buddies" to provide adherence support. Adherence rates were good for 59.2%. Disclosure of HIV status to ones' spouse (P = 0.047), knowing spouses' HIV status (P = 0.02), and having a clinic buddy (P = 0.01) were associated with good adherence. Social support is a key patient-level resource impacting ART adherence in rural Zambia. Limited spousal disclosure affects women more than men. Clinic buddies are associated with better adherence.
我们对赞比亚农村地区诊所开业后头12个月内接受抗逆转录病毒疗法（ART）治疗的患者病历进行了回顾性分析，并根据就诊情况、患者报告和工作人员评估来评估依从性。我们确定了255名符合条件的患者（平均年龄39.7岁；44.3%为男性；56.5%已婚；45.5%仅接受过小学教育）。20%的患者其伴侣已知感染艾滋病毒。20%为寡妇。37%已向配偶披露其艾滋病毒感染状况。女性披露的可能性较低（27.5%对49.6%，P = 0.0005）；36.5%有“诊所伙伴”提供依从性支持。依从率良好的占59.2%。向配偶披露艾滋病毒感染状况（P = 0.047）、知晓配偶的艾滋病毒感染状况（P = 0.02）以及有诊所伙伴（P = 0.01）与良好的依从性相关。社会支持是影响赞比亚农村地区抗逆转录病毒疗法依从性的关键患者层面资源。配偶披露有限对女性的影响大于男性。诊所伙伴与更好的依从性相关。
