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越南有吸毒史的艾滋病毒感染者的抗逆转录病毒治疗依从性和自我效能感

Antiretroviral therapy adherence and self-efficacy among people living with HIV and a history of drug use in Vietnam.

作者信息

Li Li, Lin Chunqing, Lee Sung-Jae, Tuan Le Anh, Feng Nan, Tuan Nguyen Anh

机构信息

1 Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA.

2 National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.

出版信息

Int J STD AIDS. 2017 Oct;28(12):1247-1254. doi: 10.1177/0956462417696431. Epub 2017 Mar 3.

Abstract

People living with HIV with a history of drug use face additional psychosocial challenges that could compromise their adherence to antiretroviral therapy (ART). This study examined ART treatment adherence and adherence self-efficacy among people living with HIV with a history of drug use in Vietnam. We used cross-sectional baseline data collected between October 2014 and February 2015 from a randomized controlled trial in Vietnam. Of the 900 persons with a history of drug use in the trial, a sample of 109 people living with HIV currently on ART were included in the study. The vast majority (92%) of the participants reported not missing any medications in the past 30 days. Multiple regression results indicated that social support was positively associated with adherence self-efficacy (β = 0.420, P < 0.001) and general adherence to ART (β = 0.201, P = 0.0368). General adherence to ART was negatively associated with depressive symptoms (β = -0.188, P = 0.046) and current heroin use (β = -0.196, P = 0.042). These findings underscore the importance of addressing mental health and social challenges facing people living with HIV with a history of drug use to promote ART treatment adherence. Clinical management of HIV should identify and address concurrent substance use behaviors to maximize adherence and treatment outcomes.

摘要

有吸毒史的艾滋病毒感染者面临着额外的心理社会挑战,这可能会影响他们对抗逆转录病毒疗法(ART)的依从性。本研究调查了越南有吸毒史的艾滋病毒感染者的ART治疗依从性和依从性自我效能感。我们使用了2014年10月至2015年2月期间在越南进行的一项随机对照试验收集的横断面基线数据。在该试验的900名有吸毒史的人中,109名目前正在接受ART治疗的艾滋病毒感染者被纳入研究。绝大多数(92%)参与者报告在过去30天内没有漏服任何药物。多元回归结果表明,社会支持与依从性自我效能感呈正相关(β = 0.420,P < 0.001)以及与ART的总体依从性呈正相关(β = 0.201,P = 0.0368)。ART的总体依从性与抑郁症状呈负相关(β = -0.188,P = 0.046)以及与当前使用海洛因呈负相关(β = -0.196,P = 0.042)。这些发现强调了解决有吸毒史的艾滋病毒感染者所面临的心理健康和社会挑战对于促进ART治疗依从性的重要性。艾滋病毒的临床管理应识别并解决并发的药物使用行为,以最大限度地提高依从性和治疗效果。

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