School of Social Work, University of Washington, Seattle, Washington, USA.
AIDS Patient Care STDS. 2011 Dec;25(12):735-41. doi: 10.1089/apc.2010.0261. Epub 2011 Apr 15.
China is experiencing a rapid increase in the incidence of HIV infections, which it is addressing proactively with broad implementation of antiretroviral therapy (ART). Within a cultural context extolling familial responsibility, family caregiving may be an important component to promote medication adherence for persons living with HIV in China. Based on 20 qualitative interviews with persons living with HIV and their family caregivers and a cross-sectional survey with 113 adults receiving HIV care at Beijing's Ditan outpatient clinic, this mixed-methods study examines family caregivers' role in promoting adherence to ART. Building upon a conceptual model of adherence, this article explores the role of family members in supporting four key components enhancing adherence (i.e., access, knowledge, motivation, and proximal cue to action). Patients with family caregiving support report superior ART adherence. Also, gender (being female) and less time since ART initiation are significantly related to superior adherence. Since Chinese cultural values emphasize family care, future work on adherence promotion in China will want to consider the systematic incorporation of family members.
中国的艾滋病毒感染发病率正在迅速上升,中国正在通过广泛实施抗逆转录病毒疗法(ART)积极应对这一问题。在崇尚家庭责任的文化背景下,家庭护理可能是促进中国艾滋病毒感染者遵医嘱服药的一个重要组成部分。本研究采用混合方法,通过对 20 名艾滋病毒感染者及其家庭照顾者进行定性访谈,以及对北京地坛门诊接受艾滋病毒护理的 113 名成年人进行横断面调查,探讨了家庭照顾者在促进遵医嘱服药方面的作用。本研究以遵医行为的概念模型为基础,探讨了家庭成员在支持增强遵医行为的四个关键组成部分(即获得、知识、动机和行动的近端线索)中的作用。有家庭照顾支持的患者报告说其 ART 依从性更好。此外,性别(女性)和接受 ART 治疗的时间长短与更好的依从性显著相关。由于中国的文化价值观强调家庭关怀,因此未来在中国开展的遵医行为促进工作将需要考虑系统地纳入家庭成员。