Blank Arthur E, Fletcher Jason, Verdecias Niko, Garcia Iliana, Blackstock Oni, Cunningham Chinazo
1 Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center , Bronx, New York.
AIDS Patient Care STDS. 2015 Jan;29 Suppl 1(Suppl 1):S27-35. doi: 10.1089/apc.2014.0272. Epub 2014 Dec 2.
Access to sustained HIV medical care is critical to achieving viral suppression. However, a variety of factors may impede or facilitate retention in care or becoming virally suppressed. Though retention and suppression are often treated separately, this study examined both in a cohort of 921 HIV+ women of color who participated in eight demonstration programs across the US. For women who met the inclusion criteria, 83% (n = 587) were retained and 73% (n = 357) were virally suppressed. Average age of women retained was 40.9, and 41.9 for those virally suppressed. The majority were African American/Black or Hispanic/Latina, single, and had no children less than 18 years of age, had health insurance, a high school degree or higher, were stably housed, and unemployed. Some factors associated with retention in care were indecision about seeking HIV medical care (AOR = 0.42) and having children under the age of 18 (AOR = 0.59). Some factors associated with being virally suppressed were living with others (AOR = 0.58), current substance abuse (AOR = 0.38), and fair/poor health (AOR = 0.40). The findings suggest different processes and social mechanisms may influence retention and viral suppression. Interventions seeking to improve retention in care may require tailored program components and strategies that focus on improving viral suppression.
获得持续的艾滋病毒医疗护理对于实现病毒抑制至关重要。然而,多种因素可能会阻碍或促进患者坚持接受治疗或实现病毒抑制。尽管坚持治疗和病毒抑制通常被分开对待,但本研究对参与美国八个示范项目的921名感染艾滋病毒的有色人种女性进行了这两方面的调查。对于符合纳入标准的女性,83%(n = 587)坚持接受治疗,73%(n = 357)实现了病毒抑制。坚持治疗的女性平均年龄为40.9岁,实现病毒抑制的女性平均年龄为41.9岁。大多数女性是非裔美国人/黑人或西班牙裔/拉丁裔,单身,没有18岁以下的子女,有医疗保险,拥有高中或更高学历,有稳定住房且失业。一些与坚持治疗相关的因素包括在寻求艾滋病毒医疗护理方面犹豫不决(调整后比值比[AOR]=0.42)以及有18岁以下的子女(AOR = 0.59)。一些与病毒抑制相关的因素包括与他人同住(AOR = 0.58)、目前滥用药物(AOR = 0.38)以及健康状况一般/较差(AOR = 0.40)。研究结果表明,不同的过程和社会机制可能会影响坚持治疗和病毒抑制。旨在提高治疗依从性的干预措施可能需要有针对性的项目组成部分和策略,重点是提高病毒抑制水平。