埃塞俄比亚北部接受抗逆转录病毒治疗的艾滋病毒感染患者的依从性水平及相关因素：回顾性分析
Level of Adherence and Associated Factors Among HIV-Infected Patients on Antiretroviral Therapy in Northern Ethiopia: Retrospective Analysis.
作者信息
Desta Abraham Aregay, Kidane Kibriti Mehari, Woldegebriel Ataklti Gebretsadik, Ajemu Kiros Fenta, Berhe Asfawosen Aregay, Zgita Degnesh Negash, Teweldemedhn Letebrhan Weldemhret, Woldegebriel Lemlem Legesse, Bezabih Nega Mamo, Woldearegay Tewolde Wubayehu
机构信息
Tigray Health Research Institute, Mekelle, Tigray, Ethiopia.
出版信息
Patient Prefer Adherence. 2020 Sep 3;14:1585-1594. doi: 10.2147/PPA.S268395. eCollection 2020.
BACKGROUND
Poor adherence to ART increases viremia, which leads to disease progression and transmission of drug-resistant HIV strains. This study aimed to assess the level of ART adherence and associated factors among adolescents and adult patients enrolled in ART care in Northern Ethiopia.
METHODS
A retrospective analysis was conducted among 19,525 patients from April 2015 to March 2019. Data verification and filtration were done in Excel 2013 before exporting to STATA 14.0. Ordinal logistic regression was used to analyze the data.
RESULTS
About 94.84%, 95% CI (94.52%, 95.14%) of the study subjects were in good adherence. However, about 1.46%, 95% CI (1.30%, 1.64%) and 3.70%, 95% CI (3.44%, 3.97%) of them had poor and fair adherence respectively. In the adjusted analysis, being male (AOR = 0.75; 95% CI: 0.0.65, 0.87), patients from general hospitals (AOR = 0.52; 95% CI: 0.39, 0.69), WHO staging IV (AOR = 0.57; 95% CI: 0.41, 0.81) and non-suppressed viral load (VL) status (AOR = 0.54; 95% CI: 0.47, 0.63) were negatively associated with good adherence. Whereas, age of 50+ years old (AOR = 1.68; 95% CI: 1.13, 2.50), recent CD4 count of 200-499 (AOR = 1.45; 95% CI: 1.21, 1.74) and recent CD4 count of 500 and above (AOR = 1.84; 95% CI: 1.47, 2.32) were positively associated with good ART drug adherence.
CONCLUSION
There was a higher level of adherence compared to the previous studies conducted in Ethiopia. Being male, patients from general hospitals, WHO staging II, II and IV and non-suppressed VL status were negatively associated with good adherence. Whereas, older ages, recent CD4 count of 200-499 and ≥500 CD4 count were positively associated with good ART drug adherence. The health system should recognize a higher need of younger age groups and males to design targeted counseling and support to encourage consistently high levels of adherence for a better ART treatment outcome.
背景
抗逆转录病毒治疗（ART）依从性差会增加病毒血症，进而导致疾病进展和耐药性HIV毒株的传播。本研究旨在评估埃塞俄比亚北部接受ART治疗的青少年和成年患者的ART依从性水平及相关因素。
方法
对2015年4月至2019年3月期间的19525例患者进行回顾性分析。在导出到STATA 14.0之前，先在Excel 2013中进行数据验证和筛选。采用有序逻辑回归分析数据。
结果
约94.84%（95%置信区间[CI]：94.52%，95.14%）的研究对象依从性良好。然而，分别约有1.46%（95%CI：1.30%，1.64%）和3.70%（95%CI：3.44%，3.97%）的患者依从性差和一般。在调整分析中，男性（比值比[AOR]=0.75；95%CI：0.65，0.87）、综合医院的患者（AOR=0.52；95%CI：0.39，0.69）、世界卫生组织（WHO）临床分期IV期（AOR=0.5
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