Diaz Asuncion, Ten Alicia, Marcos Henar, Gutiérrez Gonzalo, González-García Juan, Moreno Santiago, Barrios Ana María, Arponen Sari, Portillo Álvaro, Serrano Regino, García Maria Teresa, Pérez José Luis, Toledo Javier, Royo Maria Carmen, González Gustavo, Izquierdo Ana, Viloria Luis Javier, López Irene, Elizalde Lázaro, Martínez Eva, Castrillejo Daniel, Aranguren Rosa, Redondo Caridad, Diez Mercedes
Área de Vigilancia del VIH y comportamientos de riesgo, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; CIBER Epidemiología y Salud Pública (CIBERESP), Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, Madrid, España.
Plan sida, Servicio de Promoción y Protección de Salud, Subdirección General de Promoción de la Salud y Prevención, DG salud pública, Conselleria de Sanidad de Valencia, Valencia, España.
Enferm Infecc Microbiol Clin. 2015 May;33(5):324-30. doi: 10.1016/j.eimc.2014.07.009. Epub 2014 Oct 23.
To describe the occurrence of non-regular attendance to follow-up visits among HIV patients and to analyze the determining factors.
One-day survey carried out annually (2002-2012) in public hospitals. Epidemiological, clinical and behavioral data are collected in all HIV-infected inpatients and outpatients receiving HIV-related care on the day of the survey. "Non-regular attendance to a follow-up visit" was defined as sporadic attendance to the medical appointments, according to the judgment of the attending physician. Descriptive and bivariate analyses were performed, and factors associated to non-regular attendance to follow-up visits were estimated using logistic regression.
A total of 7,304 subjects were included, of whom 13.7% did not attend medical appointments regularly. Factors directly associated with non-regular attendance were: age between 25-49 years; birth in Sub-Saharan Africa or Latin-America; low educational level; being homeless or in prison; living alone or in closed institutions; being unemployed or retired; being an intravenous drug user; not using a condom at last sexual encounter, and injecting drugs in the last 30 days. Conversely, HIV diagnosis within the last year and being men who have sex with men were factors inversely associated with non-regular attendance to follow-up visits.
In spite of health care beings free of charge for everyone in Spain, social factors can act as barriers to regular attendance to medical appointments, which, in turn, can endanger treatment effectiveness in some population groups. This should be taken into account when planning HIV policies in Spain.
描述HIV患者随访就诊时不规律就诊的情况,并分析相关决定因素。
于2002年至2012年期间每年在公立医院开展为期一天的调查。在调查当日收集所有接受HIV相关治疗的住院和门诊HIV感染者的流行病学、临床和行为学数据。根据主治医生的判断,“随访就诊不规律”定义为不定期参加医疗预约。进行描述性和双变量分析,并使用逻辑回归估计与随访就诊不规律相关的因素。
共纳入7304名受试者,其中13.7%的人未定期参加医疗预约。与不规律就诊直接相关的因素包括:年龄在25至49岁之间;出生于撒哈拉以南非洲或拉丁美洲;教育水平低;无家可归或在监狱服刑;独自生活或居住在封闭机构;失业或退休;为静脉吸毒者;上次性接触时未使用避孕套,以及在过去30天内注射毒品。相反,过去一年内确诊HIV以及男男性行为者是与随访就诊不规律呈负相关的因素。
尽管在西班牙医疗保健对每个人都是免费的,但社会因素可能成为定期就诊的障碍,进而可能危及某些人群的治疗效果。在西班牙制定HIV政策时应考虑到这一点。