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行为干预可改善延迟、拒绝或中断抗逆转录病毒治疗的HIV感染者的治疗效果：一项新型干预措施的随机对照试验

Behavioral intervention improves treatment outcomes among HIV-infected individuals who have delayed, declined, or discontinued antiretroviral therapy: a randomized controlled trial of a novel intervention.

作者信息

Gwadz Marya, Cleland Charles M, Applegate Elizabeth, Belkin Mindy, Gandhi Monica, Salomon Nadim, Banfield Angela, Leonard Noelle, Riedel Marion, Wolfe Hannah, Pickens Isaiah, Bolger Kelly, Bowens DeShannon, Perlman David, Mildvan Donna

机构信息

Center for Drug Use and HIV Research (CDUHR), New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10010, USA.

Division of HIV/AIDS, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA, USA.

出版信息

AIDS Behav. 2015 Oct;19(10):1801-17. doi: 10.1007/s10461-015-1054-6.

DOI:10.1007/s10461-015-1054-6
PMID:25835462
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4567451/
Abstract

Nationally up to 60 % of persons living with HIV are neither taking antiretroviral therapy (ART) nor well engaged in HIV care, mainly racial/ethnic minorities. This study examined a new culturally targeted multi-component intervention to address emotional, attitudinal, and social/structural barriers to ART initiation and HIV care. Participants (N = 95) were African American/Black and Latino adults with CD4 < 500 cells/mm(3) not taking ART, randomized 1:1 to intervention or control arms, the latter receiving treatment as usual. Primary endpoints were adherence, evaluated via ART concentrations in hair samples, and HIV viral load suppression. The intervention was feasible and acceptable. Eight months post-baseline, intervention participants tended to be more likely to evidence "good" (that is, 7 days/week) adherence (60 vs. 26.7 %; p = 0.087; OR = 3.95), and had lower viral load levels than controls (t(22) = 2.29, p = 0.032; OR = 5.20), both large effect sizes. This highly promising intervention merits further study.

摘要

在全国范围内，高达60%的艾滋病毒感染者既未接受抗逆转录病毒治疗（ART），也未充分参与艾滋病毒护理，其中主要是少数族裔。本研究考察了一种新的针对特定文化的多成分干预措施，以解决在开始接受ART治疗和艾滋病毒护理方面的情感、态度及社会/结构障碍。参与者（N = 95）为未接受ART治疗、CD4<500个细胞/mm³的非裔美国/黑人及拉丁裔成年人，按1:1随机分为干预组或对照组，后者接受常规治疗。主要终点是依从性，通过头发样本中的ART浓度进行评估，以及艾滋病毒病毒载量抑制情况。该干预措施可行且可接受。基线后8个月，干预组参与者更有可能表现出“良好”（即每周7天）的依从性（60%对26.7%；p = 0.087；OR = 3.95），且病毒载量水平低于对照组（t(22)=2.29，p = 0.032；OR = 5.20），两者均为大效应量。这种极具前景的干预措施值得进一步研究。

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本文引用的文献

[1]
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[2]
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