2019 年西班牙 HIV 感染者的自我健康评估：一项横断面研究。
Self-rated health among people living with HIV in Spain in 2019: a cross-sectional study.
机构信息
Unidad de vigilancia de VIH, ITS y hepatitis, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, C/ Monforte de Lemos, 5, 28029, Madrid, Spain.
Servicio de Vigilancia Epidemiológica y Enfermedades Transmisibles, DG de Salud Pública, Consejería de Sanidad, Valladolid, Castilla y León, Spain.
出版信息
BMC Infect Dis. 2021 Jan 30;21(1):129. doi: 10.1186/s12879-021-05815-3.
BACKGROUND
HIV infection has become a chronic disease and well-being of people living with HIV (PLHIV) is now of particular concern. The objectives of this paper were to describe self-rated health among PLHIV, on ART and on ART virally suppressed and to analyse its determinants.
METHODS
Data were obtained from a second-generation surveillance system based on a cross-sectional one-day survey in public hospitals. Epidemiological and clinical data were collected among HIV-infected inpatients and outpatients receiving HIV-related care the day of the survey in 86 hospitals in 2019. Self-rated health was measured using a question included in the National Health Survey: "In the last 12 months, how would you rate your health status?" an ordinal variable with five categories (very good, good, moderate, bad and very bad). For the analysis, these responses were dichotomized into two categories: 1 = very good/good and 0 = moderate, bad or very bad health status. Factors associated with very good/good self-rated health were estimated using logistic regression.
RESULTS
Of 800 PLHIV, 67.5% perceived their health as very good/good, 68.4% among PLHIV on ART and 71.7% of those virally suppressed. Having university education (adjusted odds ratio (aOR):2.1), being unemployed (aOR:0.3) or retired (aOR:0.2), ever being diagnosed of AIDS (aOR:0.6), comorbidities (aOR:0.3), less than 2 year since HIV diagnosis (aOR:0.3) and not receiving ART (aOR:0.3) were associated with good self-rated health. Moreover, among PLHIV on ART, viral load less than 200 copies (aOR:3.2) were related to better perceived health. Bad adherence was inversely associated with good self-rated health among PLHIV on ART (aOR:0.5) and of those virally suppressed (aOR:0.4).
CONCLUSIONS
Nearly seven in 10 PLHIV in Spain considered their health status as very good/good, being higher among virally suppressed PLHIV. Both demographic and clinical determinants affect quality of life.
背景
HIV 感染已成为一种慢性病，艾滋病毒感染者（PLHIV）的健康状况现在尤其受到关注。本文的目的是描述接受抗逆转录病毒治疗（ART）的 PLHIV、ART 病毒抑制者以及未接受 ART 治疗的 PLHIV 的自感健康状况，并分析其决定因素。
方法
数据来自第二代监测系统，该系统基于 2019 年在 86 家医院进行的为期一天的横断面调查。在调查当天，对在这些医院接受 HIV 相关护理的住院和门诊 HIV 感染者进行了流行病学和临床数据收集。自感健康状况使用国家健康调查中的一个问题进行衡量：“在过去 12 个月中，您如何评价自己的健康状况？”这是一个五分类的有序变量（非常好、好、中等、差和非常差）。为了进行分析，这些回答被分为两类：1=非常好/好，0=中等、差或非常差的健康状况。使用逻辑回归估计与非常好/好的自感健康相关的因素。
结果
在 800 名 PLHIV 中，67.5%认为自己的健康状况非常好/好，68.4%接受 ART 治疗的 PLHIV 和 71.7%病毒抑制的 PLHIV 认为自己的健康状况非常好/好。具有大学学历（调整后的优势比（aOR）：2.1）、失业（aOR：0.3）或退休（aOR：0.2）、曾被诊断患有艾滋病（aOR：0.6）、合并症（aOR：0.3）、从 HIV 诊断到现在不到 2 年（aOR：0.3）和未接受 ART 治疗（aOR：0.3）与良好的自感健康相关。此外，在接受 ART 治疗的 PLHIV 中，病毒载量小于 200 拷贝（aOR：3.2）与更好的感知健康相关。不良的依从性与接受 ART 治疗的 PLHIV（aOR：0.5）和病毒抑制的 PLHIV（aOR：0.4）的良好自感健康呈负相关。
结论
西班牙近 70%的 PLHIV 认为自己的健康状况非常好/好，病毒抑制的 PLHIV 比例更高。人口统计学和临床因素都影响生活质量。
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