Vyas Kartavya J, Limneos Joanne, Qin Huifang, Mathews William C
a Owen Clinic , University of California San Diego Medical Center , San Diego , CA , USA.
AIDS Care. 2014;26(8):983-7. doi: 10.1080/09540121.2014.882486. Epub 2014 Feb 6.
The efficacy of highly active antiretroviral therapy (HAART) is dependent upon moderately high levels of adherence; however, predicting adherence before HAART initiation can be difficult. We conducted a prospective, longitudinal study among 350 HIV-infected adults attending a HIV clinic in San Diego, CA (USA) from January 2010 to December 2011 to examine both established and novel predictors of adherence, including religious practices and beliefs. Statistically significant (p < .05) variables identified in bivariate analyses were included in multivariate analyses predicting ≥90% adherence. Higher annual household income (p = .004) and religious affiliation (p = .031) were predictive of greater adherence. Participants who said their beliefs gave meaning to their lives, made them feel they had a connection with a higher being, were influential during their recovery, and helped them feel connected to humanity were more likely to be ≥90% adherent (p < .015). Conversely, participants who believed God created all things in the universe; that God will not turn his back on them; and those who regularly attended religious services, participated in religious rituals, and prayed and meditated to get in touch with God were less likely to be ≥90% adherent (p ≤ .025). Results indicate that a patient's religious beliefs and practices may predict medication adherence. Interventions should be designed to emphasize the use of positive religious coping strategies and address the adverse implications of religious fatalism.
高效抗逆转录病毒疗法（HAART）的疗效取决于适度较高水平的依从性；然而，在开始HAART之前预测依从性可能很困难。2010年1月至2011年12月，我们在美国加利福尼亚州圣地亚哥一家艾滋病诊所对350名感染HIV的成年人进行了一项前瞻性纵向研究，以检验依从性的既定预测因素和新的预测因素，包括宗教活动和信仰。双变量分析中确定的具有统计学意义（p <.05）的变量被纳入预测依从性≥90%的多变量分析。较高的家庭年收入（p =.004）和宗教信仰（p =.031）可预测更高的依从性。那些表示自己的信仰赋予生活意义、让他们感到与更高存在有联系、在康复过程中有影响力并帮助他们感到与人类有联系的参与者更有可能依从性≥90%（p <.015）。相反，那些相信上帝创造了宇宙万物、上帝不会抛弃他们的参与者，以及那些经常参加宗教仪式、参与宗教活动并祈祷和冥想以与上帝联系的参与者，依从性≥90%的可能性较小（p≤.025）。结果表明，患者的宗教信仰和活动可能预测药物依从性。应设计干预措施，强调使用积极的宗教应对策略，并解决宗教宿命论的不利影响。
