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法国感染艾滋病毒的女性如何应对她们所感受到的抗逆转录病毒疗法的副作用?EVE研究结果

How are women living with HIV in France coping with their perceived side effects of antiretroviral therapy? Results from the EVE study.

作者信息

Quatremère Guillemette, Guiguet Marguerite, Girardi Patricia, Liaud Marie-Noëlle, Mey Coline, Benkhoucha Cynthia, Barbier Franck, Cattaneo Graciela, Simon Anne, Rojas Castro Daniela

机构信息

AIDES, Pantin, France.

Sorbonne Universités, UPMC Univ Paris 06, INSERM, IPLESP UMRS 1136, Paris, France.

出版信息

PLoS One. 2017 Mar 6;12(3):e0173338. doi: 10.1371/journal.pone.0173338. eCollection 2017.

Abstract

OBJECTIVE

Side effects of antiretroviral therapy (ART) can have a negative impact on health-related quality of life threatening long-term retention in HIV care and adherence to ART. The aim of the French community-based survey EVE was to document personal experiences with side effects, the related physician-patient communication, and solutions found to deal with them.

DESIGN

Cross-sectional study of women between September 2013 to September 2014.

METHODS

An anonymous online questionnaire included the HIV Symptom Distress Module, which explores 20 symptoms.

RESULTS

In all, 301 women on ART participated in the study (median age: 49 years; median duration of ART: 14 years). They reported having experienced a median of 12 symptoms (Q1-Q3: 9-15) during the previous 12 months. Overall, 56% of them reported having found at least a partial solution to dealing with their symptoms. Women reporting financial difficulties were twice less likely to have found solutions to coping with their side effects (AOR: 0.5; 95% CI: 0.3-0.8). Feeling supported by the health-care provider (AOR: 2.1; 95% CI: 1.1-3.9) and being in contact with HIV/AIDS organisations (AOR: 1.9; 95% CI: 1.2-3.2) were positively associated with coping. Seventeen percent reported having modified their ART regimen to improve tolerance, with only 2 in 3 informing their physician afterwards. Reporting financial difficulties and living with more bothersome symptoms increased the risk of ART regimen modification without health-care provider consultation.

CONCLUSION

The EVE study has called attention to the large number of side effects experienced by WLWHIV, only half of whom have found self-care strategies to manage their symptoms. Modification of ART regimen by the women themselves was not uncommon.

摘要

目的

抗逆转录病毒疗法(ART)的副作用会对与健康相关的生活质量产生负面影响,威胁到长期接受HIV治疗的坚持率以及对ART的依从性。法国基于社区的EVE调查旨在记录副作用的个人经历、相关的医患沟通以及应对副作用的方法。

设计

2013年9月至2014年9月间对女性进行的横断面研究。

方法

一份匿名在线问卷包括HIV症状困扰模块,该模块探究20种症状。

结果

共有301名接受ART治疗的女性参与了研究(中位年龄:49岁;ART中位疗程:14年)。她们报告在过去12个月中经历的症状中位数为12种(四分位间距:9 - 15种)。总体而言,56%的女性报告至少找到部分应对症状的方法。报告有经济困难的女性找到应对副作用方法的可能性要低一半(调整后比值比:0.5;95%置信区间:0.3 - 0.8)。感到得到医疗服务提供者的支持(调整后比值比:2.1;95%置信区间:1.1 - 3.9)以及与HIV/艾滋病组织有联系(调整后比值比:1.9;95%置信区间:1.2 - 3.2)与应对呈正相关。17%的女性报告曾调整ART方案以提高耐受性,其中只有三分之二事后告知了医生。报告有经济困难以及出现更多困扰症状会增加未经医疗服务提供者咨询就调整ART方案的风险。

结论

EVE研究提请注意感染HIV的女性经历大量副作用,其中只有一半找到自我护理策略来管理症状。女性自行调整ART方案的情况并不少见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf60/5338806/9c7b3dfc8020/pone.0173338.g001.jpg

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