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HIV 阳性的男男性行为者中西班牙裔和拉丁裔男性抗逆转录病毒治疗依从性的障碍-美国,2015-2019 年。

Barriers to Antiretroviral Therapy Adherence Among HIV-Positive Hispanic and Latino Men Who Have Sex with Men -United States, 2015-2019.

机构信息

Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.

出版信息

MMWR Morb Mortal Wkly Rep. 2020 Oct 9;69(40):1437-1442. doi: 10.15585/mmwr.mm6940a1.


DOI:10.15585/mmwr.mm6940a1
PMID:33031362
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7561220/
Abstract

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.

摘要

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。

相似文献

[1]
Barriers to Antiretroviral Therapy Adherence Among HIV-Positive Hispanic and Latino Men Who Have Sex with Men -United States, 2015-2019.

MMWR Morb Mortal Wkly Rep. 2020-10-9

[2]
Barriers and Facilitators for Antiretroviral Treatment Adherence Among HIV-Positive African American and Latino Men Who Have Sex With Men.

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[3]
Vital Signs: HIV Infection, Diagnosis, Treatment, and Prevention Among Gay, Bisexual, and Other Men Who Have Sex with Men - United States, 2010-2019.

MMWR Morb Mortal Wkly Rep. 2021-12-3

[4]
Differences in Characteristics and Clinical Outcomes Among Hispanic/Latino Men and Women Receiving HIV Medical Care - United States, 2013-2014.

MMWR Morb Mortal Wkly Rep. 2018-10-12

[5]
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AIDS. 2024-6-1

[6]
Understanding Cross-Sectional Racial, Ethnic, and Gender Disparities in Antiretroviral Use and Viral Suppression Among HIV Patients in the United States.

Medicine (Baltimore). 2016-3

[7]
Trends in Sexual Risk Behaviors Among Hispanic/Latino Men Who Have Sex with Men - 19 Urban Areas, 2011-2017.

MMWR Morb Mortal Wkly Rep. 2019-10-11

[8]
Clinical and behavioral characteristics of adults receiving medical care for HIV infection --- Medical Monitoring Project, United States, 2007.

MMWR Surveill Summ. 2011-9-2

[9]
Behavioral and clinical characteristics of persons receiving medical care for HIV infection - Medical Monitoring Project, United States, 2009.

MMWR Suppl. 2014-6-20

[10]
Medical mistrust as a key mediator in the association between perceived discrimination and adherence to antiretroviral therapy among HIV-positive Latino men.

J Behav Med. 2017-3-23

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Arch Virol. 2025-8-19

[2]
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PLoS One. 2025-6-30

[3]
Daily Factors Associated with Antiretroviral Therapy Adherence Among Young Latino Sexual Minority Men with HIV: A 28-Day Daily Diary Study.

AIDS Behav. 2025-5-15

[4]
Efficacy and safety of bictegravir/emtricitabine/tenofovir alafenamide in Black and Hispanic/Latine adults with HIV-1 initiating first-line therapy: 5-year follow-up from two phase III studies.

HIV Med. 2025-6

[5]
Patient preferences for long-acting HIV treatment: a preference heterogeneity assessment.

BMC Infect Dis. 2025-2-19

[6]
An updated overview on long-acting therapeutics for the prevention and treatment of human immunodeficiency virus (HIV) from a perspective of pharmaceutics.

Int J Pharm. 2025-2-10

[7]
Longitudinal associations between intersectional stigmas, antiretroviral therapy adherence, and viral load among women living with HIV using multidimensional latent transition item response analysis.

Soc Sci Med. 2025-2

[8]
Psychometric Properties of Measuring Antiretroviral Therapy Adherence Among Young Latino Sexual Minority Men With HIV: Ecological Momentary Assessment and Electronic Pill Dispenser Study.

Online J Public Health Inform. 2024-11-21

[9]
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AIDS Behav. 2024-12

[10]
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AIDS Care. 2024-11

本文引用的文献

[1]
Analysis of Systematic Reviews of Medication Adherence Interventions for Persons with HIV, 1996-2017.

AIDS Patient Care STDS. 2019-11-21

[2]
Barriers and Facilitators for Antiretroviral Treatment Adherence Among HIV-Positive African American and Latino Men Who Have Sex With Men.

AIDS Educ Prev. 2019-8

[3]
Ending the HIV Epidemic: A Plan for the United States.

JAMA. 2019-3-5

[4]
Interventions to improve adherence to antiretroviral therapy: a systematic review and network meta-analysis.

Lancet HIV. 2016-11-16

[5]
Validation of a New Three-Item Self-Report Measure for Medication Adherence.

AIDS Behav. 2016-11

[6]
Perspectives on the role of patient-centered medical homes in HIV Care.

Am J Public Health. 2014-5-15

[7]
Cognitive and field testing of a new set of medication adherence self-report items for HIV care.

AIDS Behav. 2014-12

[8]
Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data.

Am J Epidemiol. 2010-2-4

[9]
The role of ancillary services in client-centred systems of care.

AIDS Care. 2002-8

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