在乌干达北部农村的社区护理模式中，艾滋病毒感染者的酒精消费增加了他们对 ART 的不依从性。
Alcohol consumption increases non-adherence to ART among people living with HIV enrolled to the community-based care model in rural northern Uganda.
机构信息
The AIDS Support Organization, Center of Clinical Excellence, Gulu, Uganda.
Department of Business Studies, Faculty of Management Studies, Islamic University in Uganda, Mbale, Uganda.
出版信息
PLoS One. 2020 Nov 24;15(11):e0242801. doi: 10.1371/journal.pone.0242801. eCollection 2020.
BACKGROUND
Non-adherence to anti-retroviral therapy (ART) is associated with considerable morbidity and mortality among people living with Human Immunodeficiency Virus (PLHIV). Community-based ART delivery model offers a decentralized and patient-centered approach to care for PLHIV, with the advantage of improved adherence to ART hence good treatment outcomes. However, data are limited on the magnitude of non-adherence to ART among PLHIV enrolled to the community-based ART model of care. In this study, we determined the frequency of non-adherence to ART and the associated factors among PLHIV enrolled to the community-based ART delivery model in a large health facility in rural northern Uganda.
METHODS
This analytic cross-sectional study randomly sampled participants from 21 community drug distribution points at the AIDS Support Organization (TASO) in Gulu district, northern Uganda. Data were collected using a standardized and pre-tested questionnaire, entered in Epi-Data and analyzed in Stata at univariate, bivariate, and multivariate analyses levels. Binary logistic regression analysis was used to determine factors independently associated with non-adherence to ART, reported using odds ratio (OR) and 95% confidence level (CI). The level of statistical significance was 5%.
RESULTS
Of 381 participants, 25 (6.6%) were non-adherent to ART and this was significantly associated with alcohol consumption (Adjusted (aOR), 3.24; 95% CI, 1.24-8.34). Other factors namely being single/or never married (aOR, 1.97; 95% CI, 0.62-6.25), monthly income exceeding 27 dollars (aOR, 1.36; 95% CI, 0.52-3.55), being on ART for more than 5 years (aOR, 0.60; 95% CI, 0.23-1.59), receipt of health education on ART side effects (aOR, 0.36; 95% CI, 0.12-1.05), and disclosure of HIV status (aOR, 0.37; 95% CI, 0.04-3.20) were not associated with non-adherence in this setting.
CONCLUSION
Non-adherence to ART was low among PLHIV enrolled to community-based ART delivery model but increases with alcohol consumption. Accordingly, psychosocial support programs should focus on alcohol consumption.
背景
抗逆转录病毒疗法（ART）不依从与艾滋病毒感染者（PLHIV）的发病率和死亡率密切相关。以社区为基础的 ART 提供模式为 PLHIV 提供了一种分散和以患者为中心的护理方法，其优点是提高了对 ART 的依从性，从而获得良好的治疗效果。然而，关于参加以社区为基础的 ART 护理模式的 PLHIV 不依从 ART 的程度的数据有限。在这项研究中，我们确定了在乌干达北部一个大型卫生设施中参加以社区为基础的 ART 提供模式的 PLHIV 不依从 ART 的频率和相关因素。
方法
这是一项分析性横断面研究，在乌干达北部的古卢地区艾滋病支持组织（TASO）的 21 个社区药物分发点随机抽取参与者。使用标准化和预先测试的问卷收集数据，将数据输入 Epi-Data 并在 Stata 中进行单变量、双变量和多变量分析。使用二元逻辑回归分析确定与 ART 不依从独立相关的因素，使用比值比（OR）和 95%置信区间（CI）报告。统计显著性水平为 5%。
结果
在 381 名参与者中，有 25 名（6.6%）不依从 ART，这与饮酒显著相关（调整后的（aOR），3.24；95%CI，1.24-8.34）。其他因素，即单身/从未结婚（aOR，1.97；95%CI，0.62-6.25）、月收入超过 27 美元（aOR，1.36；95%CI，0.52-3.55）、接受 ART 副作用健康教育（aOR，0.36；95%CI，0.12-1.05）和 HIV 状态披露（aOR，0.37；95%CI，0.04-3.20）与该环境中的不依从无关。
结论
参加以社区为基础的 ART 提供模式的 PLHIV 中 ART 不依从率较低，但随着饮酒量的增加而增加。因此，社会心理支持计划应重点关注饮酒问题。
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