Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.
MMWR Morb Mortal Wkly Rep. 2020 Oct 9;69(40):1437-1442. doi: 10.15585/mmwr.mm6940a1.
During 2018, estimated incidence of human immunodeficiency virus (HIV) infection among Hispanic and Latino (Hispanic/Latino) persons in the United States was four times that of non-Hispanic White persons (1). Hispanic/Latino men who have sex with men (MSM) accounted for 24% (138,023) of U.S. MSM living with diagnosed HIV infection at the end of 2018 (1). Antiretroviral therapy (ART) adherence is crucial for viral suppression, which improves health outcomes and prevents HIV transmission (2). Barriers to ART adherence among Hispanic/Latino MSM have been explored in limited contexts (3); however, nationally representative analyses are lacking. The Medical Monitoring Project reports nationally representative estimates of behavioral and clinical experiences of U.S. adults with diagnosed HIV infection. This analysis used Medical Monitoring Project data collected during 2015-2019 to examine ART adherence and reasons for missing ART doses among HIV-positive Hispanic/Latino MSM (1,673). On a three-item ART adherence scale with 100 being perfect adherence, 77.3% had a score of ≥85. Younger age, poverty, recent drug use, depression, and unmet needs for ancillary services were predictors of lower ART adherence. The most common reason for missing an ART dose was forgetting; 63.9% of persons who missed ≥1 dose reported more than one reason. Interventions that support ART adherence and access to ancillary services among Hispanic/Latino MSM might help improve clinical outcomes and reduce transmission.
2018 年,美国西班牙裔和拉丁裔(拉美裔)人群中人类免疫缺陷病毒(HIV)感染的估计发病率是未感染 HIV 的非西班牙裔白人的四倍(1)。2018 年底,美国男男性行为者(MSM)中感染 HIV 并被诊断的人群中,拉美裔 MSM 占 24%(138023 人)(1)。抗逆转录病毒治疗(ART)的依从性对病毒抑制至关重要,这可以改善健康结果并预防 HIV 传播(2)。在有限的背景下已经探讨了拉美裔 MSM 中影响 ART 依从性的因素(3);然而,缺乏全国代表性的分析。医疗监测项目报告了具有诊断性 HIV 感染的美国成年人行为和临床经验的全国代表性估计。本分析使用医疗监测项目在 2015-2019 年期间收集的数据,调查了 HIV 阳性拉美裔 MSM 的 ART 依从性和漏服 ART 剂量的原因(1673 人)。在一项包含 100 分满分的 3 项 ART 依从性量表中,77.3% 的人得分≥85 分。年龄较小、贫困、最近吸毒、抑郁和未满足的辅助服务需求是 ART 依从性较低的预测因素。漏服 ART 剂量最常见的原因是遗忘;63.9%漏服≥1 剂的人报告了不止一个原因。支持拉美裔 MSM 中 ART 依从性和获得辅助服务的干预措施可能有助于改善临床结果并减少传播。
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