Ayer Rakesh, Kikuchi Kimiyo, Ghimire Mamata, Shibanuma Akira, Pant Madhab Raj, Poudel Krishna C, Jimba Masamine
Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Health Care Policy and Management, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 301-8577, Japan.
PLoS One. 2016 Jul 20;11(7):e0159382. doi: 10.1371/journal.pone.0159382. eCollection 2016.
HIV-positive people's clinic attendance for medication pick-up is critical for successful HIV treatment. However, limited evidence exists on it especially in low-income settings such as Nepal. Moreover, the role of family support in clinic attendance remains under-explored. Therefore, this study was conducted to examine the association between perceived family support and regular clinic attendance and to assess factors associated with regular clinic attendance for antiretroviral pills pick-up among HIV-positive individuals in Nepal.
A cross-sectional study was conducted among 423 HIV-positive people in three districts of Nepal. Clinic attendance was assessed retrospectively for the period of 12 months. To assess the factors associated, an interview survey was conducted using a semi-structured questionnaire from July to August, 2015. Multiple logistic regression models were used to assess the factors associated with regular clinic attendance.
Of 423 HIV-positive people, only 32.6% attended the clinics regularly. They were more likely to attend them regularly when they received high family support (AOR = 3.98, 95% CI = 2.29, 6.92), participated in support programs (AOR = 1.68, 95% CI = 1.00, 2.82), and had knowledge on the benefits of antiretroviral therapy (AOR = 2.62, 95% CI = 1.15, 5.99). In contrast, they were less likely to attend them regularly when they commuted more than 60 minutes to the clinics (AOR = 0.53, 95% CI = 0.30, 0.93), when they self-rated their health status as being very good (AOR = 0.13, 95% CI = 0.04, 0.44), good (AOR = 0.14, 95% CI = 0.04, 0.46), and fair (AOR = 0.21, 95% CI = 0.06, 0.70).
HIV-positive individuals are more likely to attend the clinics regularly when they receive high family support, know the benefits of antiretroviral therapy, and participate in support programs. To improve clinic attendance, family support should be incorporated with HIV care programs in resource limited settings. Service providers should also consider educating them about the benefits of antiretroviral therapy.
艾滋病毒呈阳性者前往诊所领取药物对于成功进行艾滋病毒治疗至关重要。然而，关于这方面的证据有限，尤其是在尼泊尔这样的低收入环境中。此外，家庭支持在就诊方面的作用仍未得到充分探索。因此，本研究旨在探讨感知到的家庭支持与定期就诊之间的关联，并评估尼泊尔艾滋病毒呈阳性个体中与定期前往诊所领取抗逆转录病毒药物相关的因素。
在尼泊尔三个地区对423名艾滋病毒呈阳性者进行了一项横断面研究。回顾性评估了12个月期间的就诊情况。为评估相关因素，于2015年7月至8月使用半结构化问卷进行了访谈调查。采用多元逻辑回归模型评估与定期就诊相关的因素。
在423名艾滋病毒呈阳性者中，只有32.6%的人定期前往诊所。当他们获得高度家庭支持（比值比[AOR]=3.98，95%置信区间[CI]=2.29，6.92）、参加支持项目（AOR=1.68，95%CI=1.00，2.82）以及了解抗逆转录病毒疗法的益处（AOR=2.62，95%CI=1.15，5.99）时，他们更有可能定期前往诊所。相比之下，当他们前往诊所的通勤时间超过60分钟（AOR=0.53，95%CI=0.30，0.93）、自我评定健康状况为非常好（AOR=0.13，95%CI=0.04，0.44）、良好（AOR=0.14，95%CI=0.04，0.46）和中等（AOR=0.21，95%CI=0.06，0.70）时，他们定期前往诊所的可能性较小。
艾滋病毒呈阳性个体在获得高度家庭支持、了解抗逆转录病毒疗法的益处并参加支持项目时，更有可能定期前往诊所。为提高就诊率，在资源有限的环境中，应将家庭支持纳入艾滋病毒护理项目。服务提供者还应考虑向他们宣传抗逆转录病毒疗法的益处。
