Bezabih Tsegazeab, Weiser S D, Menbere Meherete-Selassie, Negash Afework, Grede Nils
a World Food Programme Ethiopia Country Office , Addis Ababa , Ethiopia.
b Division of HIV, ID and Global Medicine, Department of Medicine , San Francisco General Hospital, University of California , San Francisco , CA , USA.
AIDS Care. 2018 Mar;30(3):369-377. doi: 10.1080/09540121.2017.1371667. Epub 2017 Aug 31.
Economic strengthening (ES) interventions are increasingly promoted to support the economic well-being and food security of people living with HIV (PLHIV) in resource poor settings. This study aims to assess the impact of ES interventions in Ethiopia designed to address poverty and food insecurity on antiretroviral treatment (ART) adherence. A comparative cross-sectional design was employed to compare treatment adherence between food insecure PLHIV benefitting from the ES project of WFP Ethiopia to food insecure PLHIV not participating in ES. Using the visual analogue scale (VAS) to measure ART adherence, only 9.9% of the ES group reported less than 95% adherence compared to 25.9% of the comparison group. Controlling for socio-economic and demographic variables using logistic regression models, engagement in ES activities increased the likelihood of having 95% or greater ART adherence by a factor of 2.4 and 5.6 respectively (as measured by VAS and ACTG approaches) compared to those PLHIV that were not engaged in ES. The findings of the study suggest that engagement in ES contributes to improved ART adherence among food insecure PLHIV. If further studies validate this result, ES should be adopted as a key strategy to improve HIV treatment adherence in resource poor settings where adherence is an issue of concern.
经济强化（ES）干预措施越来越多地得到推广，以支持资源匮乏地区艾滋病毒感染者（PLHIV）的经济福祉和粮食安全。本研究旨在评估埃塞俄比亚旨在解决贫困和粮食不安全问题的ES干预措施对抗逆转录病毒治疗（ART）依从性的影响。采用比较横断面设计，比较受益于埃塞俄比亚世界粮食计划署ES项目的粮食不安全PLHIV与未参与ES的粮食不安全PLHIV之间的治疗依从性。使用视觉模拟量表（VAS）来衡量ART依从性，ES组中只有9.9%的人报告依从性低于95%，而对照组为25.9%。使用逻辑回归模型控制社会经济和人口变量，与未参与ES的PLHIV相比，参与ES活动使ART依从性达到95%或更高的可能性分别提高了2.4倍和5.6倍（通过VAS和ACTG方法衡量）。该研究结果表明，参与ES有助于提高粮食不安全PLHIV的ART依从性。如果进一步的研究验证了这一结果，在依从性是一个令人担忧问题的资源匮乏地区，ES应被采纳为改善艾滋病毒治疗依从性的关键策略。
