Culbert Gabriel J, Bazazi Alexander R, Waluyo Agung, Murni Astia, Muchransyah Azalia P, Iriyanti Mariska, Polonsky Maxim, Levy Judith, Altice Frederick L
Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL, 60612, USA.
Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia.
AIDS Behav. 2016 May;20(5):1026-38. doi: 10.1007/s10461-015-1198-4.
Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.
对艾滋病药物的消极态度可能会限制印度尼西亚监狱中抗逆转录病毒疗法（ART）的使用，在这些监狱里，许多艾滋病毒感染者（PLH）被诊断出来并首次获得抗逆转录病毒疗法。这项混合方法研究考察了药物态度对印度尼西亚感染艾滋病毒囚犯抗逆转录病毒疗法使用情况的影响。随机选取的感染艾滋病毒的男性囚犯（n = 102）完成了面对面深入访谈以及评估抗逆转录病毒疗法态度的结构化调查。结果显示，虽然一半的参与者使用了抗逆转录病毒疗法，但符合抗逆转录病毒疗法资格标准的参与者中有四分之一没有使用。未使用抗逆转录病毒疗法的参与者更担心该疗法的疗效、安全性和副作用，并且更确定对于感觉健康的艾滋病毒感染者应该推迟使用抗逆转录病毒疗法。在多变量分析中，抗逆转录病毒疗法的使用与更积极的抗逆转录病毒疗法态度（调整后比值比[AOR] = 1.09，95%置信区间[CI] 1.03 - 1.16，p = 0.002）以及更高的内化艾滋病毒污名感（AOR = 1.03，95% CI 1.00 - 1.07，p = 0.016）独立相关。需要对抗逆转录病毒疗法进行社会营销，以抵消那些限制印度尼西亚囚犯使用抗逆转录病毒疗法的消极态度。
