Gross Robert, Bandason Tsitsi, Langhaug Lisa, Mujuru Hilda, Lowenthal Elizabeth, Ferrand Rashida
a Center for Clinical Epidemiology & Biostatistics (CCEB), Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA.
AIDS Care. 2015;27(3):322-6. doi: 10.1080/09540121.2014.969676. Epub 2014 Oct 22.
Nonadherence to medication is the key obstacle to human immunodeficiency virus (HIV) treatment success. The group at highest risk of nonadherence is adolescents, but relatively little is known about risk factors for and protective factors against poor adherence in this age group. We undertook a cross-sectional study of 262 HIV-infected adolescents aged 10-19 years on antiretroviral therapy at two clinics in Harare, Zimbabwe, to investigate personal and system-level factors associated with optimal self-reported adherence. Suboptimal adherence was common with only 101 (39%) reporting "excellent" adherence. Having the guardian present at each clinical encounter, comfort with asking questions to the health provider and participating in group sessions led by a professional facilitator were all significantly associated with excellent adherence (p < 0.05). Strengthening the parent-child dyad and professional-led groups as strategies to improve adherence should be evaluated.
不坚持服药是人类免疫缺陷病毒（HIV）治疗成功的关键障碍。不坚持服药风险最高的群体是青少年，但对于该年龄组中导致服药依从性差的风险因素和保护因素，我们了解得相对较少。我们在津巴布韦哈拉雷的两家诊所，对262名年龄在10至19岁、正在接受抗逆转录病毒治疗的HIV感染青少年进行了一项横断面研究，以调查与自我报告的最佳依从性相关的个人和系统层面因素。次优依从性很常见，只有101人（39%）报告“极佳”依从性。每次临床就诊时监护人在场、对向医疗服务提供者提问感到自在以及参与由专业主持人主持的小组会议，均与极佳依从性显著相关（p<0.05）。应评估强化亲子关系和以专业人员为主导的小组作为改善依从性策略的效果。
