Dworkin Mark S, Douglas G W, Sabitha Rani G P, Chakraborty Apurba
School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
Int J STD AIDS. 2016 Mar;27(3):186-95. doi: 10.1177/0956462415578545. Epub 2015 Mar 22.
We assessed the barriers and facilitators to highly active antiretroviral therapy adherence and determined their prevalence among HIV/AIDS patients in Hyderabad, India. We conducted a cross-sectional study among HIV-infected adults prescribed highly active antiretroviral therapy and receiving care from nine clinics. Depression was screened using Patient Health Questionnaire 9 and facilitators of HIV medication adherence were assessed using an 11-item scale which yielded a total positive attitude to disease score. Prevalence ratios of non-adherence between different categories of potential risk factors were calculated. We compared mean 'facilitators to adherence' scores between the adherent and non-adherent population. Multivariable Poisson regression with robust variance was used to identify independent risk factors. Among the 211 respondents, nearly 20% were non-adherent, approximately 8% had either moderately severe or severe depression and mean score for combined facilitators to medication adherence was 33.35 (±7.88) out of a possible 44 points. Factors significantly associated with non-adherence included older age, female sex worker, moderate-to-severe depression and the combined facilitators to medication adherence score. These data from a broad range of clinical settings in Hyderabad reveal that key groups to focus on for adherence intervention are female sex workers, older persons and those with depression.
我们评估了高效抗逆转录病毒疗法依从性的障碍和促进因素，并确定了它们在印度海得拉巴市艾滋病毒/艾滋病患者中的流行情况。我们对接受高效抗逆转录病毒疗法并在九家诊所接受治疗的艾滋病毒感染成年人进行了一项横断面研究。使用患者健康问卷9筛查抑郁症，并使用一个11项量表评估艾滋病毒药物依从性的促进因素，该量表得出对疾病的总体积极态度得分。计算不同类别潜在风险因素之间不依从的患病率比。我们比较了依从人群和不依从人群之间的平均“依从促进因素”得分。使用具有稳健方差的多变量泊松回归来识别独立风险因素。在211名受访者中，近20%不依从，约8%患有中度严重或重度抑郁症，药物依从性综合促进因素的平均得分在可能的44分中为33.35（±7.88）。与不依从显著相关的因素包括年龄较大、女性性工作者、中度至重度抑郁症以及药物依从性综合促进因素得分。来自海得拉巴市广泛临床环境的这些数据表明，依从性干预应重点关注的关键群体是女性性工作者、老年人和抑郁症患者。
