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秘鲁转诊医院中患者提名的支持者作为促进 HIV 护理参与的助力者:一项回顾性队列研究。

Patient-nominated supporters as facilitators for engagement in HIV care in a referral hospital in Peru: A retrospective cohort study.

机构信息

Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

Carlos Vidal Layseca School of Public Health and Management, Universidad Peruana Cayetano Heredia, Lima, Peru.

出版信息

PLoS One. 2018 Apr 4;13(4):e0195389. doi: 10.1371/journal.pone.0195389. eCollection 2018.

Abstract

Patient-nominated supporters can potentially improve the continuum of HIV care. We retrospectively determined factors associated with having a patient-nominated supporter among people living with HIV (PLWH), and its association with retention in care and viral suppression. We analysed registries of adults evaluated by social workers (n = 1345) at a referral hospital in Peru between 2011-2014. Nondisclosure of HIV status was associated with lacking supporters (aPR: 5.41, 95% CI: 3.83-7.64). Retention in care was 76.4% and 34.2% after one and two years of enrolment, respectively. PLWH with supporters were more likely to be retained in care after two years (aRR = 1.36, 95% CI: 1.02-1.81), but not after one year (aRR = 1.10, 95% CI: 0.98-1.23) compared to PLWH without supporters. Having supporters who were parents or friends was associated with an increased probability of being retained in care after one and two years of enrolment. Viral suppression after one year of enrolment was 58.7%. Having a supporter was not associated with viral suppression (aRR = 1.18, 95% CI: 0.99-1.41), but PLWH with supporters were more likely to have viral load measurements (p = 0.005). Patient-nominated supporters appear beneficial for engagement in HIV care; these benefits may be related to the nature of their relationship with PLWH.

摘要

患者提名的支持者可能会改善 HIV 护理的连续性。我们回顾性地确定了与 HIV 感染者(PLWH)中存在患者提名的支持者相关的因素,以及其与保持护理和病毒抑制的关联。我们分析了 2011 年至 2014 年间秘鲁一家转诊医院社会工作者评估的 1345 名成年人的登记册。HIV 感染者未透露其状况与缺乏支持者有关(调整后的比值比[aPR]:5.41,95%可信区间[CI]:3.83-7.64)。分别在入组后一年和两年时,PLWH 的保留率为 76.4%和 34.2%。有支持者的 PLWH 在入组两年后更有可能保持护理(调整后的相对风险[aRR] = 1.36,95%CI:1.02-1.81),但在入组一年后则不然(aRR = 1.10,95%CI:0.98-1.23)。有父母或朋友作为支持者与在入组一年和两年后保持护理的可能性增加有关。入组一年后的病毒抑制率为 58.7%。有支持者与病毒抑制无关(调整后的相对风险[aRR] = 1.18,95%CI:0.99-1.41),但有支持者的 PLWH 更有可能进行病毒载量测量(p = 0.005)。患者提名的支持者似乎有益于参与 HIV 护理;这些好处可能与他们与 PLWH 的关系性质有关。

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