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韩国全国性理赔研究:HIV 感染年轻女性中的药物治疗依从性不足。

Suboptimal medication adherence in young women living with HIV infection: a Korean nationwide claims study.

机构信息

Division of Infectious diseases, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea.

Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.

出版信息

AIDS Care. 2021 Jul;33(7):938-942. doi: 10.1080/09540121.2020.1844863. Epub 2020 Nov 10.

Abstract

The epidemiological characteristics of women living with human immunodeficiency virus (HIV) infection have gained little attention as the numbers are small compared with men living with HIV in the Republic of Korea. However, these data are important to achieve effective HIV infection control and to consider the influence of socioeconomic status on HIV transmission. This study utilized the claims database of the Korean National Health Insurance system to analyze women with a newly diagnosed HIV infection during the period 2009-2016. Adherence to antiretroviral agents was calculated using the medication possession ratio. Among 677 women with a newly diagnosed HIV infection, 219 (32.4%) were over 50 years of age; 291 (43.0%) were identified as having acquired immune deficiency syndrome (AIDS). A total of 99 women (14.6%) were National Medical Aid beneficiaries. Optimal medical adherence >95% was found in 62.2% of subjects. Teenage years (odds ratio(OR) 14.9, 95% confidence interval (95CI) 4.9-44.8), AIDS (OR 1.7, 95CI 1.2-2.3), and low economic status requiring National Medical Aid (OR 3.0, 95CI 2.0-4.6) were associated to adherence. Diagnosis prior to 2012 was also associated with poor adherence. In women, particularly young patients with low economic status, extra attention is required to enhance adherence to prescribed medication.

摘要

在韩国,与男性 HIV 感染者相比,女性 HIV 感染者的人数较少,因此她们的流行病学特征很少受到关注。然而,这些数据对于实现有效的 HIV 感染控制以及考虑社会经济地位对 HIV 传播的影响非常重要。本研究利用韩国国家健康保险系统的理赔数据库,分析了 2009 年至 2016 年间新诊断出 HIV 感染的女性患者。采用药物维持率来计算抗逆转录病毒药物的依从性。在 677 名新诊断出 HIV 感染的女性中,219 名(32.4%)年龄超过 50 岁;291 名(43.0%)被诊断为获得性免疫缺陷综合征(AIDS)。共有 99 名(14.6%)女性是国家医疗救助受益者。62.2%的患者达到了最佳的药物依从性(>95%)。青少年时期(比值比[OR]14.9,95%置信区间[95CI]4.9-44.8)、艾滋病(OR 1.7,95CI 1.2-2.3)和需要国家医疗救助的低经济地位(OR 3.0,95CI 2.0-4.6)与药物依从性相关。2012 年前的诊断也与较差的药物依从性相关。在女性中,特别是经济地位较低的年轻患者,需要特别注意提高对规定药物的依从性。

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