Peltzer Karl, Pengpid Supa
HIV/AIDS/SIT/ and TB (HAST), Human Sciences Research Council, Pretoria, South Africa.
J Health Popul Nutr. 2013 Jun;31(2):150-70. doi: 10.3329/jhpn.v31i2.16379.
It is not clear what effect socioeconomic factors have on adherence to antiretroviral therapy (ART) among patients in low- and middle-income countries. We performed a systematic review of the association of socioeconomic status (SES) with adherence to treatment of patients with HIV/AIDS in low- and middle-income countries. We searched electronic databases to identify studies concerning SES and HIV/AIDS and collected data on the association between various determinants of SES (income, education, occupation) and adherence to ART in low- and middle-income countries. From 252 potentially-relevant articles initially identified, 62 original studies were reviewed in detail, which contained data evaluating the association between SES and adherence to treatment of patients with HIV/AIDS. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 15 studies (41.7%), 10 studies (20.4%), and 3 studies (11.1%) respectively out of 36, 49, and 27 studies reviewed. One study for income, four studies for education, and two studies for employment found a negative and significant association with adherence to ART. However, the aforementioned SES determinants were not found to be significantly associated with adherence in relation to 20 income-related (55.6%), 35 education-related (71.4%), 23 employment/occupational status-related (81.5%), and 2 SES-related (100%) studies. The systematic review of the available evidence does not provide conclusive support for the existence of a clear association between SES and adherence to ART among adult patients infected with HIV/ AIDS in low- and middle-income countries. There seems to be a positive trend among components of SES (income, education, employment status) and adherence to antiretroviral therapy in many of the reviewed studies.
目前尚不清楚社会经济因素对低收入和中等收入国家患者坚持抗逆转录病毒治疗（ART）有何影响。我们对低收入和中等收入国家社会经济地位（SES）与艾滋病毒/艾滋病患者治疗依从性之间的关联进行了系统评价。我们检索了电子数据库以识别有关SES和艾滋病毒/艾滋病的研究，并收集了低收入和中等收入国家SES的各种决定因素（收入、教育、职业）与ART依从性之间关联的数据。从最初识别出的252篇潜在相关文章中，详细审查了62项原创研究，这些研究包含评估SES与艾滋病毒/艾滋病患者治疗依从性之间关联的数据。在审查的36项、49项和27项研究中，收入、教育水平和就业/职业状况分别在15项研究（41.7%）、10项研究（20.4%）和3项研究（11.1%）中与依从水平呈显著正相关。一项关于收入的研究、四项关于教育的研究和两项关于就业的研究发现与ART依从性呈负相关且具有显著性。然而，在20项与收入相关（55.6%）、35项与教育相关（71.4%）、23项与就业/职业状况相关（81.5%）以及2项与SES相关（100%）的研究中，上述SES决定因素与依从性未发现显著关联。对现有证据的系统评价并未为低收入和中等收入国家感染艾滋病毒/艾滋病的成年患者中SES与ART依从性之间存在明确关联提供确凿支持。在许多审查的研究中，SES的组成部分（收入、教育、就业状况）与抗逆转录病毒治疗的依从性之间似乎存在积极趋势。
