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印度北部地区两家三级护理医院中艾滋病毒/艾滋病患者的抗逆转录病毒治疗不依从情况

Nonadherence to Antiretroviral Therapy Among People Living with HIV/AIDS Attending Two Tertiary Care Hospitals in District of Northern India.

作者信息

Shukla Mukesh, Agarwal Monika, Singh Jai Vir, Tripathi Anil Kumar, Srivastava Anand Kumar, Singh Vijay Kumar

机构信息

Department of Community Medicine and Public Health, King George's Medical University, Lucknow, Uttar Pradesh, India.

Department of Clinical Hematology, King George's Medical University, Lucknow, Uttar Pradesh, India.

出版信息

Indian J Community Med. 2016 Jan-Mar;41(1):55-61. doi: 10.4103/0970-0218.170970.

Abstract

INTRODUCTION

Adherence to antiretroviral therapy is a principal predictor for the success of human immunodeficiency virus (HIV) treatment. It remains as a challenge to acquired immunodeficiency syndrome (AIDS) treatment and care with the widespread of the associated risks. Therefore, study aims to assess nonadherence level and factors associated with nonadherence to ART among people living with HIV/AIDS (PLHA).

MATERIALS AND METHODS

A hospital-based, cross-sectional study was conducted at two tertiary care hospital of Lucknow. A total of 322 adult HIV-positive patients registered in the ART center were included. Systematic random sampling was used to recruit patients. Nonadherence was assessed on the basis of pill count method.

RESULTS

A total of 10.9% of patients were found to be nonadherent to ART. Principal causes cited were being busy with other work (40.0%), felt sick or ill (28.5%), not having money (14.2%), and being away from home (11.4). Multivariate logistic regression analysis revealed that nonadherence was significantly associated with nonbeneficial perceptions towards ART (odds ratio (OR) 18.5; 95% confidence interval (CI) 3.2-106.6; P = 0.001), being counseled for adherence for more than 3 months (OR 13.9; 95% CI 1.6-118.9; P = 0.01), presence of depression (OR 2.6; 95% CI 1.0-6.7; P = 0.04), and those who were not satisfied with healthcare facilities (OR 5.63; 95% CI 1.88-16.84; P = 0.00).

CONCLUSION

Although adherence to ART varies between individuals and over time, the factors that affect nonadherence can be addressed with proper periodic counseling and motivation of patients and their family members. Adherence to highly active antiretroviral therapy (HAART) could delay the progression of this lethal disease and minimize the risk of developing drug resistance.

摘要

引言

坚持抗逆转录病毒治疗是人类免疫缺陷病毒(HIV)治疗成功的主要预测指标。随着相关风险的广泛存在,这仍然是获得性免疫缺陷综合征(AIDS)治疗和护理面临的一项挑战。因此,本研究旨在评估艾滋病毒/艾滋病感染者(PLHA)中抗逆转录病毒治疗(ART)的不依从水平及与不依从相关的因素。

材料与方法

在勒克瑙的两家三级护理医院进行了一项基于医院的横断面研究。纳入了ART中心登记的322名成年HIV阳性患者。采用系统随机抽样法招募患者。基于药丸计数法评估不依从情况。

结果

共发现10.9%的患者不坚持ART治疗。列举的主要原因有忙于其他工作(40.0%)、感觉不适或生病(28.5%)、没钱(14.2%)以及离家在外(11.4%)。多因素逻辑回归分析显示,不依从与对ART治疗的负面认知显著相关(比值比(OR)18.5;95%置信区间(CI)3.2 - 106.6;P = 0.001)、接受依从性咨询超过3个月(OR 13.9;95% CI 1.6 - 118.9;P = 0.01)、存在抑郁(OR 2.6;95% CI 1.0 - 6.7;P = 0.04)以及对医疗设施不满意的患者(OR 5.63;95% CI 1.88 - 16.84;P = 0.00)。

结论

尽管ART治疗的依从性因人而异且随时间变化,但通过对患者及其家庭成员进行适当的定期咨询和激励,可以解决影响不依从的因素。坚持高效抗逆转录病毒治疗(HAART)可以延缓这种致命疾病的进展,并将产生耐药性的风险降至最低。

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