社会支持与高效抗逆转录病毒治疗成人病毒载量的关系 - 南非威茨堡。

Association between social support and viral load in adults on highly active antiretroviral therapy - Witbank, South Africa.

机构信息

Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria.

出版信息

S Afr Fam Pract (2004). 2020 Dec 3;62(1):e1-e7. doi: 10.4102/safp.v62i1.5139.

DOI:10.4102/safp.v62i1.5139

PMID:33314941

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8378151/

Abstract

BACKGROUND

There are significant number of patients who are on highly active antiretroviral therapy (HAART) not virally suppressed, which is a huge clinical challenge. Social support as a non-pharmacological factor, which may influence the viral suppression, is less studied and has equivocal results. The aim of this study was to investigate the association between social support and viral load (VL) in adults on HAART.

METHODS

This was an analytical cross-sectional study. Using a structured questionnaire, 380 adults (≥ 18 years) on HAART for ≥ 6 months were recruited between November 2018 and February 2019 from Witbank hospital and surrounding clinics. Multivariable logistic regression was carried out.

RESULTS

The mean age of the participants was 40.5 years (s.d. = 10.3). The majority were females (73%), at least high school educated (84%), unemployed (57%), single (63%) and did not have comorbidity (80%). The vast majority had moderate to high adherence (84%) and moderate to good perceived social support (94%). The viral suppression rate was 87%. Both adherence (p 0.001) and social support (p = 0.017) were significantly associated with VL. However, only adherence was predictive of viral suppression in multivariable analysis. Compared to poorly adherent, moderately (OR = 2.8; 95% CI = 1.32-5.98) and highly (OR = 5.3; 95% CI = 2.41-11.81) adherent participants were more likely to have suppressed VL.

CONCLUSION

Viral suppression rate was high. Self-reported adherence to HAART was highly predictive of viral suppression, which highlights the importance of assessing and addressing adherence issues at every contact with patients taking HAART. Good social support did not predict viral suppression.

摘要

背景

有相当数量的患者接受高效抗逆转录病毒治疗（HAART）但并未病毒抑制，这是一个巨大的临床挑战。社会支持作为一种非药物因素，可能会影响病毒抑制，但研究较少，结果也存在争议。本研究旨在探讨社会支持与接受 HAART 的成年人病毒载量（VL）之间的关系。

方法

这是一项分析性横断面研究。2018 年 11 月至 2019 年 2 月，我们从威特班克医院和周边诊所招募了 380 名接受 HAART 治疗≥6 个月的成年人（≥18 岁），使用结构化问卷进行调查。采用多变量逻辑回归进行分析。

结果

参与者的平均年龄为 40.5 岁（标准差=10.3）。大多数参与者为女性（73%），至少受过高中教育（84%）、失业（57%）、单身（63%），且无合并症（80%）。绝大多数患者具有中高度的药物依从性（84%）和中高度的感知社会支持（94%）。病毒抑制率为 87%。依从性（p<0.001）和社会支持（p=0.017）均与 VL 显著相关。然而，仅依从性是多变量分析中预测病毒抑制的因素。与依从性差的患者相比，中高度（OR=2.8；95%CI=1.32-5.98）和高度（OR=5.3；95%CI=2.41-11.81）依从性的患者更有可能实现 VL 抑制。