HIV/Aids, STI and TB Unit, Human Sciences Research Council, Private Bag X41, Pretoria 0001, South Africa.
Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Int J Environ Res Public Health. 2018 Jan 20;15(1):161. doi: 10.3390/ijerph15010161.
The possibility for all babies to be born and remain HIV-negative for the first year of life is achievable in South Africa. HIV-positive mothers' adherence to their antiretroviral medication is one of the crucial factors to achieve this target. Cross-sectional data were collected at 12 community health centres, over 12 months (2014-2015), from 673 HIV-positive women, less than 6 months pregnant, attending antenatal care, and on Option B treatment. Adherence measures included the Adults AIDS Clinical Trials Group (AACTG) four-day measure, as well as the Visual Analog Scale (VAS) seven-day measure. Bivariate analyses and multivariate logistic regressions are presented. 78.8% of respondents were adherent on AACTG, while 68.8% reported VAS adherence. Bivariate analyses for increased adherence show significant associations with older age, less/no alcohol usage, disclosure of HIV status, higher HIV knowledge, no desire to avoid ARV side effects, low stigma, and low depression. AACTG showed a negative association with intimate partner violence. Multivariable logistic regression on AACTG and VAS adherence rates resulted in unique contributions to increased adherence of older age, less/no alcohol usage, higher HIV knowledge, lack of depression, and non-disclosure. Programs targeting closer side effect monitoring, HIV disclosure, pre-natal depression, alcohol intake, and HIV knowledge need consideration.
在南非,所有婴儿都有可能在生命的第一年出生并保持 HIV 阴性。HIV 阳性母亲坚持服用抗逆转录病毒药物是实现这一目标的关键因素之一。本研究于 2014 年至 2015 年在 12 个社区卫生中心,对 673 名不到 6 个月大的、正在接受产前护理且正在接受 B 方案治疗的 HIV 阳性孕妇进行了为期 12 个月的横断面数据收集。依从性测量包括成人艾滋病临床试验组(AACTG)的 4 天测量和视觉模拟量表(VAS)的 7 天测量。报告了描述性统计、双变量分析和多变量逻辑回归。78.8%的受访者在 AACTG 上表现出较高的依从性,而 68.8%的受访者报告了 VAS 依从性。增加依从性的双变量分析显示,与年龄较大、较少/不饮酒、HIV 状况披露、较高的 HIV 知识、不希望避免 ARV 副作用、低耻辱感和低抑郁有关。AACTG 与亲密伴侣暴力呈负相关。对 AACTG 和 VAS 依从率进行多变量逻辑回归分析,结果表明,年龄较大、较少/不饮酒、较高的 HIV 知识、无抑郁以及未披露是增加依从性的独特因素。需要考虑针对副作用监测、HIV 披露、产前抑郁、饮酒和 HIV 知识的项目。