抗逆转录病毒疗法治疗新诊断的 HIV 感染者的药物依从性。
Medication adherence to antiretroviral therapy among newly treated people living with HIV.
机构信息
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, 410078, China.
Hunan Provincial Center for Disease Prevention and Control, Changsha, China.
出版信息
BMC Public Health. 2018 Jul 4;18(1):825. doi: 10.1186/s12889-018-5731-z.
BACKGROUND
Free antiretroviral therapy has been implemented in China since 2004, but adherence to antiretroviral therapy among people living with HIV is suboptimal. The effectiveness of antiretroviral therapy is subject to medication adherence, which decreases with prolonged treatment times. The aim of this study was to investigate medication adherence and related factors among people living with HIV with newly initiated antiretroviral therapy.
METHODS
This observational study was conducted in consecutive samples of people living with HIV who had newly initiated antiretroviral therapy. Participants were recruited between March 1, 2013, and August 31, 2014, from the local Center for Disease Control and Prevention and Infectious Disease hospital in a capital city in central China. A standard set of questionnaires was adopted, including the Community Programs for Clinical Research on AIDS Antiretroviral Medications and Self-Report Questionnaire (CPCRA), the Patient Health Questionnaire-9 (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). T-test, Chi square test and multivariate logistic regression analysis with backward stepwise were performed to explore factors that might influence medication adherence.
RESULTS
Of the 207 participants, 85.5% of the participants (177/207) were categorized with good adherence, and 14.5% (30/207) with poor adherence. The multivariate logistic regression analyses showed that participants with positive depression (OR = 5.95, 95% CI: 2.34-15.11) and without disclosure of their HIV status to others (OR = 2.62, 95% CI: 1.06-6.50) were more susceptible to poor adherence.
CONCLUSIONS
One-sixth of the participants reported suboptimal medication adherence within the first 6 months. Factors associated with poor adherence included non-disclosure of their HIV status, had positive depression. Tailored interventions, such as effective psychological coping strategies, should be implemented for people living with HIV with newly initiated antiretroviral therapy to improve their medication adherence.
背景
中国自 2004 年开始实施免费抗逆转录病毒治疗，但艾滋病毒感染者的抗逆转录病毒治疗依从性并不理想。抗逆转录病毒治疗的效果取决于药物的依从性，而随着治疗时间的延长，依从性会下降。本研究旨在调查新接受抗逆转录病毒治疗的艾滋病毒感染者的药物依从性及其相关因素。
方法
这是一项连续抽样观察性研究，研究对象为新接受抗逆转录病毒治疗的艾滋病毒感染者。参与者于 2013 年 3 月 1 日至 2014 年 8 月 31 日期间从当地疾病预防控制中心和中国中部省会城市传染病医院招募。采用了一套标准的问卷，包括社区艾滋病临床研究计划抗逆转录病毒药物和自我报告问卷（CPCRA）、患者健康问卷-9（PHQ-9）和 7 项广泛性焦虑症量表（GAD-7）。采用 t 检验、卡方检验和逐步后退多元逻辑回归分析来探讨可能影响药物依从性的因素。
结果
在 207 名参与者中，85.5%（177/207）的参与者被归类为依从性良好，14.5%（30/207）的参与者依从性差。多元逻辑回归分析显示，有抑郁阳性（OR=5.95，95%CI：2.34-15.11）和未向他人透露艾滋病毒状况（OR=2.62，95%CI：1.06-6.50）的参与者更有可能依从性差。
结论
在最初的 6 个月内，有六分之一的参与者报告药物依从性不理想。与依从性差相关的因素包括未透露艾滋病毒状况、抑郁阳性。应针对新接受抗逆转录病毒治疗的艾滋病毒感染者实施有针对性的干预措施，如有效的心理应对策略，以提高他们的药物依从性。
Zotero 插件