Igumbor J O, Scheepers E, Ebrahim R, Jason A, Grimwood A
North West University, Mafikeng, South Africa.
AIDS Care. 2011 Feb;23(2):231-6. doi: 10.1080/09540121.2010.498909.
This study assessed the impact of a community-based adherence support service on the outcomes of patients on antiretroviral therapy (ART). The evaluation was a retrospective study based on patient clinical records. This study noted that a significantly higher proportion of patients with a community-based adherence supporter (also known as a patient advocate, PA) had viral load (VL) of less than 400 copies/ml at six months of treatment (70%, p=0.001); a significantly higher proportion of patients with PAs (89%) attained a treatment pickup rate of over 95% (67%; p=0.021). Patients at health facilities with PA services maintained a suppressed VL for a longer period as opposed to patients at health facilities without PA services (p=0.001), also patients at health facilities with PA services remained in care for longer periods (p=0.001). Therefore, the study concludes that integrated community-based adherence support is crucial in ensuring that patients remain in care, regularly pickup their treatment from ART clinics and are virologically suppressed. The study also underscores the importance of access to health services and the presence of an enabling environment in the treatment of AIDS.
本研究评估了一项基于社区的依从性支持服务对抗逆转录病毒疗法（ART）患者治疗结果的影响。该评估是一项基于患者临床记录的回顾性研究。本研究指出，在接受治疗六个月时，拥有社区依从性支持者（也称为患者倡导者，PA）的患者中，病毒载量（VL）低于400拷贝/毫升的比例显著更高（70%，p = 0.001）；拥有PA的患者中，治疗取药率达到95%以上的比例显著更高（89%，而无PA的患者为67%；p = 0.021）。与没有PA服务的医疗机构的患者相比，有PA服务的医疗机构的患者病毒载量被抑制的时间更长（p = 0.001），而且有PA服务的医疗机构的患者接受治疗的时间也更长（p = 0.001）。因此，该研究得出结论，基于社区的综合依从性支持对于确保患者持续接受治疗、定期从ART诊所取药以及实现病毒学抑制至关重要。该研究还强调了获得卫生服务以及在艾滋病治疗中拥有有利环境的重要性。
