Abgrall Sophie, Fugon Lionel, Lélé Nathalie, Carde Estelle, Bentata Michelle, Patey Olivier, Khuong Marie-Aude, Spire Bruno, Carrieri Patrizia, Bouchaud Olivier
AP-HP, Hôpital Avicenne, Bobigny, France.
J Int Assoc Provid AIDS Care. 2013 Nov-Dec;12(6):407-13. doi: 10.1177/2325957413488181. Epub 2013 May 22.
The aim of this study was to evaluate to what extent travel-related factors may cause adherence failure to antiretroviral therapy (ART) in otherwise adherent migrants when traveling back to Africa. HIV-infected sub-Saharian migrants living in France with a plasma HIV viral load < 200 copies/mL, with no change in ART for ≥3 months and who were about to visit their native country for between 2 weeks and 6 months were enrolled for the study. Patients completed a self-administered adherence questionnaire both at enrollment and during the week following their return to France. Adherence failure occurred in 23 (11.5%) of 200 patients. Negative perception about ART effectiveness (adjusted odds ratio = 4.3; 95% confidence interval = 1.3-13.7), unexpected traumatic events during their stay in their native country (7.8; 2.3-26.1), and a prolongation of their stay (5.2; 1.4-20.4) were independently associated with a higher likelihood of adherence failure. Owning/renting one's house in France (0.30; 0.10-0.96), singlehood (0.23; 0.05-1.00), and HIV status disclosure (0.19; 0.05-0.76) were correlates of sustained adherence during traveling.
本研究的目的是评估旅行相关因素在多大程度上可能导致原本坚持抗逆转录病毒治疗（ART）的移民在返回非洲时治疗依从性失败。纳入了居住在法国、血浆HIV病毒载量<200拷贝/mL、ART方案至少3个月未改变且即将回国探亲2周至6个月的撒哈拉以南HIV感染移民进行研究。患者在入组时以及返回法国后的一周内完成一份自我管理的依从性问卷。200名患者中有23名（11.5%）出现治疗依从性失败。对ART有效性的负面认知（调整优势比=4.3；95%置信区间=1.3-13.7）、在其祖国停留期间发生的意外创伤事件（7.8；2.3-26.1）以及停留时间延长（5.2；1.4-20.4）与治疗依从性失败的较高可能性独立相关。在法国拥有/租赁自己的房屋（0.30；0.10-0.96）、单身（0.23；0.05-1.00）以及HIV感染状况披露（0.19；0.05-0.76）是旅行期间持续依从性的相关因素。
