Hadaye Rujuta S, Jambhale Vyankat B, Shastri Shruti
Department of Community Medicine, Seth. G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India.
E.S.I.S. Hospital, Aurangabad, Maharashtra, India.
J Family Med Prim Care. 2020 Apr 30;9(4):1921-1926. doi: 10.4103/jfmpc.jfmpc_1138_19. eCollection 2020 Apr.
For the successful treatment of human immunodeficiency virus (HIV), it is important that drugs should be taken regularly. Non-adherence not only increases chances of failure of treatment but also leads to the development of resistance to drugs and hence more focus has been given to adherence in the treatment protocol of HIV.
To determine the level of adherence, its determinants, and to ascertain reasons for non-adherence of antiretroviral therapy (ART) in patients with HIV/acquired immunodeficiency syndrome (AIDS).
A cross-sectional study conducted at an adult ART clinic over a period of one year. The sample size was 320. A systematic random sampling technique was used. Semi-structured Adult AIDS Clinical Trials Group questionnaire was used. Beck Depression Inventory (BDI-II) for current depression and self-report of four days recall method and multi-method approach were used for adherence measurement.
The mean age of respondents was 37.26 ± 8.3 years. About 60.3% were males, 34.1% females, and 5.6% were transgenders (TGs). High adherence was found in 87.2% by self-report and 72.5% by multi-method approach. History of opportunistic infection and depression were found to be the best predictors of adherence. Reasons for short term non-adherence were found to be simply forgot to take medications, being away from home, busy with other things, and ran out of pills. Reasons for long-term non-adherence were financial difficulty, side-effects, and shift to alternate therapy.
Significant non-adherence to ART necessitates addressing adherence issues in pre-ART counseling, the involvement of family and social support.
为成功治疗人类免疫缺陷病毒（HIV），定期服药很重要。不坚持服药不仅会增加治疗失败的几率，还会导致对药物产生耐药性，因此在HIV治疗方案中对坚持服药给予了更多关注。
确定HIV/获得性免疫缺陷综合征（AIDS）患者抗逆转录病毒疗法（ART）的坚持水平、其决定因素，并查明不坚持服药的原因。
在一家成人ART诊所进行了为期一年的横断面研究。样本量为320。采用系统随机抽样技术。使用了半结构化的成人艾滋病临床试验组问卷。采用贝克抑郁量表（BDI-II）评估当前抑郁状况，并采用四天回忆法自我报告和多方法进行坚持服药情况测量。
受访者的平均年龄为37.26±8.3岁。约60.3%为男性，34.1%为女性，5.6%为跨性别者（TGs）。自我报告显示87.2%的患者坚持服药情况良好，多方法评估显示72.5%的患者情况良好。机会性感染史和抑郁被发现是坚持服药的最佳预测因素。短期不坚持服药的原因是单纯忘记服药以及离家外出、忙于其他事情和药片用完。长期不坚持服药的原因是经济困难、副作用以及改用替代疗法。
ART存在显著的不坚持服药情况，这就需要在ART前咨询中解决坚持服药问题，并让家庭和社会提供支持。
