Office of Program Evaluation and Research, AIDS Institute, New York State Department of Health, Albany, 12204, USA.
AIDS Behav. 2011 Oct;15(7):1416-28. doi: 10.1007/s10461-010-9762-4.
Stress, substance use and medication beliefs are among the most frequently cited barriers to HIV treatment adherence. This study used longitudinal techniques to examine the temporal relationship between these barriers and adherence among clients attending treatment adherence support programs in New York State. A total of 4,155 interview pairs were analyzed across three interview transitions. Multinomial models were constructed with four-category change-based independent variables (e.g., low stress at both interviews, low stress at interview 1 and high stress at interview 2, high stress at interview 1 and low stress at interview 2, high stress at both interviews) that predicted a similarly constructed four-category adherence change variable. Clients who reported positive changes in stress, substance use, or medication beliefs were more likely to change from being nonadherent to being adherent, while clients who reported negative changes were more likely to change from being adherent to being nonadherent. To improve or maintain adherence over time, strategies should be used that facilitate positive changes-and prevent negative changes-in stress, substance use, and medication beliefs.
压力、物质使用和药物信念是最常被提到的阻碍 HIV 治疗依从性的因素之一。本研究使用纵向技术，在纽约州接受治疗依从性支持项目的患者中，考察了这些障碍与依从性之间的时间关系。共有 4155 对访谈在三次访谈转变中进行了分析。使用基于四类变化的自变量（例如，两次访谈时压力均较低、第一次访谈时压力较低，第二次访谈时压力较高、第一次访谈时压力较高，第二次访谈时压力较低、两次访谈时压力均较高）构建了多项模型，这些自变量预测了同样构建的四类依从性变化变量。报告压力、物质使用或药物信念出现积极变化的患者更有可能从不依从转变为依从，而报告出现消极变化的患者更有可能从依从转变为不依从。为了随着时间的推移提高或维持依从性，应该采用促进压力、物质使用和药物信念发生积极变化和防止发生消极变化的策略。
