Department of Social Sciences, Pontificia Universidad Javeriana, Cali, Colombia.
Rev Panam Salud Publica. 2009 Dec;26(6):502-10. doi: 10.1590/s1020-49892009001200005.
To assess and analyze the associations between adherence to treatment and social position in women living with HIV/AIDS.
A cross-sectional, descriptive, correlational study among 269 Colombian women was conducted. Participants completed three questionnaires: a socio-demographic and clinical characteristics survey, a treatment adherence scale, and a social position survey.
Women of low social position had a significantly higher probability of low treatment adherence (OR = 5.651, P < 0.0001), and the majority of social position variables measured had a significant effect on adherence. A general model considering the variables 'type of national health care plan' ('contributive,' 'subsidized,' or, in the case of vinculadas or the uninsured, 'none'); 'having HIV-positive children'; and 'level of viral load' was statistically reliable in predicting study participants' treatment adherence. Membership in the subsidized plan or being uninsured had a greater effect on the probability of low adherence than membership in the contributive plan (OR = 3.478, P < 0.0001). Univariate regression analyses confirmed that women with HIV-positive children and a viral load > 400 copies/ml were more likely to have low adherence than women without those characteristics (OR = 2.395, P = 0.0274 and OR = 2.178, P = 0.0050, respectively).
Improving women's adherence to HIV/AIDS treatment in Colombia would require eliminating barriers to national health care system and comprehensive health care services and implementing programs that take into account women's role as maternal caregivers The findings underscore the need to integrate variables related to gender inequality and social position in treatment adherence analysis, as advocated in the social determinants of health approach.
评估和分析感染艾滋病毒/艾滋病的妇女治疗依从性与社会地位之间的关系。
这是一项针对 269 名哥伦比亚女性的横断面、描述性、相关性研究。参与者完成了三份问卷：社会人口学和临床特征调查、治疗依从性量表和社会地位调查。
社会地位较低的女性治疗依从性较低的可能性显著更高（OR = 5.651，P < 0.0001），且测量的大多数社会地位变量对依从性有显著影响。考虑到“国家卫生保健计划类型”（“缴费”、“补贴”或 vinculadas 或无保险的“无”）、“有 HIV 阳性子女”和“病毒载量”等变量的一般模型，在预测研究参与者的治疗依从性方面具有统计学可靠性。参加补贴计划或无保险比参加缴费计划对低依从性的概率影响更大（OR = 3.478，P < 0.0001）。单变量回归分析证实，有 HIV 阳性子女和病毒载量> 400 拷贝/ml 的女性比没有这些特征的女性更有可能出现低依从性（OR = 2.395，P = 0.0274 和 OR = 2.178，P = 0.0050）。
要提高哥伦比亚艾滋病毒/艾滋病女性患者的治疗依从性，就需要消除国家卫生保健系统和全面卫生保健服务的障碍，并实施考虑到女性作为母婴照顾者的角色的方案。研究结果强调了需要将与性别不平等和社会地位相关的变量纳入治疗依从性分析中，正如健康的社会决定因素方法所倡导的那样。
