新时代抗逆转录病毒药物治疗背景下，HIV 感染者青少年服药依从性的社会认知因素多中心研究。
A Multi-Site Study of Social Cognitive Factors Related to Adherence Among Youth Living With HIV in the New Era of Antiretroviral Medication.
机构信息
Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine.
Department of Quantitative Health Sciences, University of Massachusetts Medical School.
出版信息
J Pediatr Psychol. 2019 Jan 1;44(1):98-109. doi: 10.1093/jpepsy/jsy076.
OBJECTIVE
The goal of the current study was to determine how a set of social cognitive factors predict antiretroviral therapy (ART) medication adherence in youth living with HIV in an era of newer highly active ART medications using a conceptual model.
METHODS
Behaviorally infected youth living with HIV ages 13-24 (N = 822) from 14 sites within the Adolescent Medicine Trials Unit (AMTU) were included in the study. Structural equation modeling was used to explore predictors of ART medication adherence.
RESULTS
Results found that motivational readiness for ART was related to higher ART medication adherence, which was associated with lower viral load. Higher social support and higher self-efficacy had an indirect relationship with higher adherence through increased motivational readiness. Fewer psychological symptoms were associated with higher social support and higher self-efficacy. Lower substance use was directly associated with lower adherence.
CONCLUSIONS
The results provide insight into factors that may be related to adherence in youth living with HIV. Findings suggest focusing on motivational readiness to increase adherence. Improving the patients' ART self-efficacy and strengthening their social support networks during treatment can increase motivational readiness for ART treatment. Furthermore, programs maybe more effective with the inclusion of risk reduction components especially those related to substance use.
目的
本研究旨在通过概念模型，确定在新型高效抗逆转录病毒治疗（ART）药物时代，一组社会认知因素如何预测感染 HIV 的青少年接受抗逆转录病毒治疗（ART）药物的依从性。
方法
本研究纳入了来自青少年医学试验单位（AMTU）的 14 个研究点的 13-24 岁感染 HIV 的青少年（N=822）。采用结构方程模型探讨 ART 药物依从性的预测因素。
结果
研究结果发现，接受 ART 的动机准备与更高的 ART 药物依从性相关，而更高的 ART 药物依从性与更低的病毒载量相关。更高的社会支持和更高的自我效能感通过增加动机准备与更高的依从性呈间接关系。较少的心理症状与更高的社会支持和更高的自我效能感相关。较少的物质使用与较低的依从性直接相关。
结论
研究结果为了解与 HIV 感染者的依从性相关的因素提供了深入的见解。研究结果表明，关注接受 ART 的动机准备以提高依从性。在治疗过程中提高患者的 ART 自我效能感并加强他们的社会支持网络，可以增加他们接受 ART 治疗的动机准备。此外，包含减少风险的内容，特别是与物质使用相关的内容，可能会使方案更有效。
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