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埃塞俄比亚南部阿尔巴明奇镇行政区公共卫生设施中接受高效抗逆转录病毒治疗的成年HIV感染者生活质量低下的决定因素。

Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia.

作者信息

Legesse Tesemma Abel, Girma Abate Meseret, Hailemariam Abebo Zeleke, Estifanos Madebo Wubshet

机构信息

Bona General Hospital, Hawassa, Sidama, Ethiopia.

Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia.

出版信息

HIV AIDS (Auckl). 2019 Dec 31;11:387-394. doi: 10.2147/HIV.S227244. eCollection 2019.

Abstract

BACKGROUND

The human immunodeficiency virus (HIV) continues to be a major global public health problem with more than 35 million people worldwide infected so far. Evidence shows that HIV has been compromising the quality of life of people living with HIV (PLWH) even in this era of highly active anti-retroviral therapy (HAART). There has been little research into the quality of life of PLWH receiving HAART in Ethiopia.

PURPOSE

The aim of this study was to assess the quality of life among PLWH attending anti-retroviral therapy at public health facilities of Arba Minch town, Southern Ethiopia, in 2019.

PATIENTS AND METHODS

We conducted a cross-sectional study design on 391 randomly selected PLWH who were attending HAART. We used a systematic random sampling technique to select participants in public health facilities of Arba Minch town from February 16 to April 26, 2019. The interviewers administered a structured questionnaire consisting of the WHOQOL-HIV BREF tool to measure the quality of life. Socio-demographic variables of study participants were collected, together with variables related to their clinical status extracted from their clinical records. Percentage mean scores were calculated and the mean of percentage mean scores was taken as the cutoff to categorize participants into two groups representing poor and good quality of life. Simple binary logistic regression and multivariable logistic regression analyses were used to determine significant variables. All variables with p-value ≤ 0.25 in simple binary logistic regression were considered as eligible variables for multivariable logistic regression. Variables with p-value ≤ 0.05 in multivariable logistic regression were considered as predictor variables.

RESULTS

Out of the 391 enrolled adult PLWH, 184 of them (47.1%) had poor of overall quality of life status, as estimated by the WHOQOL-HIV BREF tool. Good quality of life was positively associated with recent CD4 count greater than or equal to 500 cell/mm (AOR=1.96, 95% CI; 1.18-3.27), absence of depression (AOR=10.59, 95% CI; 6.16-18.21), normal body mass index (AOR=2.66, 95% CI; 1.18-3.27), social support (AOR= 6.18, 95% CI; 3.56-10.75) and no perceived stigma (AOR=2.75, 95% CI; 1.62-4.67).

CONCLUSION

Nearly half of the adult PLWH receiving HAART at Arba Minch town had poor quality of life. High CD4 count, lack of social support, depression, and perceived stigma were associated with poor quality of life of PLWH. PLWH should be encouraged to be part of structured social support systems, such as associations of people living with HIV and mother support groups, in order to improve their social and psychological health. The health system should give attention to counseling on chronic care adherence and nutritional support to improve the quality of life of PLWH receiving HAART.

摘要

背景

人类免疫缺陷病毒(HIV)仍然是一个主要的全球公共卫生问题,迄今为止全球有超过3500万人感染。有证据表明,即使在高效抗逆转录病毒治疗(HAART)时代,HIV也一直在损害艾滋病病毒感染者(PLWH)的生活质量。在埃塞俄比亚,对接受HAART治疗的PLWH的生活质量研究甚少。

目的

本研究的目的是评估2019年在埃塞俄比亚南部阿尔巴米琴镇公共卫生机构接受抗逆转录病毒治疗的PLWH的生活质量。

患者与方法

我们对391名随机选择的接受HAART治疗的PLWH进行了横断面研究设计。我们采用系统随机抽样技术,于2019年2月16日至4月26日在阿尔巴米琴镇的公共卫生机构中选取参与者。访谈者使用一份由WHOQOL-HIV BREF工具组成的结构化问卷来测量生活质量。收集了研究参与者的社会人口统计学变量,以及从他们的临床记录中提取的与他们临床状况相关的变量。计算百分比平均得分,并将百分比平均得分的平均值作为临界值,将参与者分为代表生活质量差和生活质量好的两组。使用简单二元逻辑回归和多变量逻辑回归分析来确定显著变量。在简单二元逻辑回归中p值≤0.25的所有变量被视为多变量逻辑回归的合格变量。在多变量逻辑回归中p值≤0.05的变量被视为预测变量。

结果

根据WHOQOL-HIV BREF工具估计,在391名登记的成年PLWH中,有184人(47.1%)的总体生活质量较差。生活质量良好与近期CD4细胞计数大于或等于500个细胞/mm³呈正相关(调整后比值比[AOR]=1.96,95%置信区间[CI]:1.18 - 3.27),无抑郁(AOR=10.59,95% CI:6.16 - 18.21),正常体重指数(AOR=2.66,95% CI:1.18 - 3.27),社会支持(AOR=6.18,95% CI:3.56 - 10.75)以及无感知耻辱感(AOR=2.75,95% CI:1.62 - 4.67)相关。

结论

在阿尔巴米琴镇接受HAART治疗的成年PLWH中,近一半生活质量较差。高CD4细胞计数、缺乏社会支持、抑郁和感知耻辱感与PLWH的生活质量差有关。应鼓励PLWH加入结构化的社会支持系统,如艾滋病病毒感染者协会和母亲支持小组,以改善他们的社会和心理健康。卫生系统应关注慢性护理依从性咨询和营养支持,以提高接受HAART治疗的PLWH的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9358/6948197/64ff9357542b/HIV-11-387-g0001.jpg

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