Ketema Abush Kebede, Shewangizaw Weret Zewdu
Regional Monitoring and Evaluation Advisor, Management Sciences for Health, Addis Ababa, Ethiopia.
College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia.
HIV AIDS (Auckl). 2015 Mar 11;7:75-81. doi: 10.2147/HIV.S79328. eCollection 2015.
Patient adherence to antiretroviral combination therapy is a critical component to successful treatment outcome. Nonadherence to antiretroviral therapy (ART) is a major challenge to AIDS care, and the risks associated with it are extensive. The intention of this study was to determine prevalence and associated factors with adherence to highly active ART among people living with HIV/AIDS (PLWHA) at the Debrebrihan Referral Hospital and Health Center, Northeast Ethiopia. A cross-sectional study design with systematic random sampling conducted by the use of a structured, pretested self-rating adherence questionnaire was used to conduct the study among 422 respondents from the Debrebrihan Referral Hospital and Health Center. A single population proportion formula at 95% CI with 5% of marginal error at 50% of prevalence of occurrence was used to determine sample size. Adherence was defined as not missing a single ART dose during the 30-day period prior to filling out the self-report. Adherence was measured by self-reports by the patients. These results were then used in binary logistic regression analysis. Covariates were analyzed by bivariate and multivariate logistic regression with SPSS statistical software. The total number of respondents in this study was 422; their median age was 35 years. Among the participants, 95.5% were taking their medication without missing a dose. Factors such as having emotional or practical support positively encouraged ART adherence (adjusted odds ratio 0.16 [95% CI 0.05-0.49]). However, users of traditional, complementary, and alternative medicine (TCAM) (adjusted odds ratio 4.7 [95% CI 1.06-21.22]) had nearly a five times higher risk for ART nonadherence (P<0.05) than those not using TCAM. Adherence to ART among PLWA is imperative and standard. But, there is still a need to boost psychological support and practical support for the clients, and there is also a need to create a more integrative approach with TCAM in order to increase adherence to ART. Strengthening emotional and practical support for PLWHA and integrating TCAM with the proper use of ART are mandatory to enhance ART adherence.
患者对抗逆转录病毒联合疗法的依从性是治疗取得成功的关键因素。不坚持抗逆转录病毒疗法（ART）是艾滋病护理面临的一项重大挑战，与之相关的风险广泛。本研究旨在确定埃塞俄比亚东北部德布雷布里汉转诊医院和健康中心的艾滋病毒/艾滋病患者（PLWHA）中坚持高效抗逆转录病毒疗法的患病率及相关因素。采用横断面研究设计，通过系统随机抽样，使用一份结构化、经过预测试的自评依从性问卷，对来自德布雷布里汉转诊医院和健康中心的422名受访者进行了研究。使用在发生率为50%时边际误差为5%的95%置信区间的单总体比例公式来确定样本量。依从性定义为在填写自我报告前的30天内未漏服一剂抗逆转录病毒药物。依从性通过患者的自我报告来衡量。然后将这些结果用于二元逻辑回归分析。使用SPSS统计软件通过双变量和多变量逻辑回归分析协变量。本研究的受访者总数为422人；他们的年龄中位数为35岁。在参与者中，95.5%的人按时服药，无一漏服。诸如获得情感或实际支持等因素对坚持抗逆转录病毒疗法有积极促进作用（调整后的优势比为0.16 [95%置信区间为0.05 - 0.49]）。然而，使用传统、补充和替代医学（TCAM）的人（调整后的优势比为4.7 [95%置信区间为1.06 - 21.22]）不坚持抗逆转录病毒疗法的风险几乎是未使用TCAM者的五倍（P<0.05）。PLWHA坚持抗逆转录病毒疗法至关重要且是标准要求。但是，仍然需要加强对患者的心理支持和实际支持，还需要创建一种与TCAM更综合的方法，以提高对抗逆转录病毒疗法的依从性。加强对PLWHA的情感和实际支持，并将TCAM与正确使用抗逆转录病毒疗法相结合，对于提高抗逆转录病毒疗法的依从性是必不可少的。
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