Crowley Talitha, van der Merwe Anita, Kidd Martin, Skinner Donald
Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Centre for Statistical Consultation, Stellenbosch University, Cape Town, South Africa.
South Afr J HIV Med. 2020 Apr 29;21(1):1054. doi: 10.4102/sajhivmed.v21i1.1054. eCollection 2020.
With the advent of access to antiretroviral treatment (ART), human immunodeficiency virus (HIV) has become a chronic disease and self-management is an important component of its care. Research to date has not explored associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and health-related quality of life (HRQoL).
To explore the associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and HRQoL.
A quantitative cross-sectional study of 385 adolescents living with HIV (ALHIV) aged 13-18 years, who were recruited from 11 healthcare facilities between March and August 2017 in the Cape Metropole of the Western Cape, South Africa, provided the data that were examined in this self-completed questionnaire. Validated scales were used to measure key variables. The most recent viral load (VL) was obtained from the participants' clinic folder, taking into account that VL is done annually.
Adolescents who reported higher HIV self-management were more likely to be adherent to treatment ( = 4.435 [336], < 0.01), virally suppressed ( = 2.376 [305], = 0.02) and to practise consistent condom use ( = 1.947 [95], = 0.54). Structural equation modelling (SEM) indicated a significant relationship between self-management and HRQoL ( = 0.43, < 0.01), whilst non-adherent treatment taking behaviour, correlated with elevated VL log values. No significant correlation was found between self-management and sexual risk behaviour.
Targeting adolescents' skills related to HIV self-management in the clinical setting may improve adolescents' treatment taking behaviour, viral suppression rates and their HRQoL.
随着抗逆转录病毒治疗（ART）的出现，人类免疫缺陷病毒（HIV）已成为一种慢性病，自我管理是其护理的重要组成部分。迄今为止的研究尚未探讨青少年HIV自我管理与治疗依从性、病毒抑制、性风险行为及健康相关生活质量（HRQoL）之间的关联。
探讨青少年HIV自我管理与治疗依从性、病毒抑制、性风险行为及HRQoL之间的关联。
对385名年龄在13 - 18岁的感染HIV的青少年（ALHIV）进行了一项定量横断面研究，这些青少年于2017年3月至8月期间从南非西开普省开普敦都会区的11个医疗机构招募而来，通过这份自填问卷提供了相关数据。使用经过验证的量表来测量关键变量。考虑到病毒载量（VL）每年检测一次，从参与者的临床档案中获取其最新的病毒载量。
报告HIV自我管理水平较高的青少年更有可能坚持治疗（β = 4.435 [336]，p < 0.01）、实现病毒抑制（β = 2.376 [305]，p = 0.02）并坚持正确使用避孕套（β = 1.947 [95]，p = 0.54）。结构方程模型（SEM）表明自我管理与HRQoL之间存在显著关系（β = 0.43，p < 0.01），而不坚持服药行为与VL对数数值升高相关。未发现自我管理与性风险行为之间存在显著相关性。
在临床环境中针对青少年与HIV自我管理相关的技能进行干预，可能会改善青少年的服药行为、病毒抑制率及其HRQoL。
