喀麦隆雅温得的艾滋病毒感染孕妇的心理健康不良、家庭饥饿和亲密伴侣暴力对其抗逆转录病毒治疗依从性的综合影响。
The syndemic effects of mental ill health, household hunger, and intimate partner violence on adherence to antiretroviral therapy among pregnant women living with HIV in Yaoundé, Cameroon.
机构信息
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
School of Nursing, Columbia University, New York, New York, United States of America.
出版信息
PLoS One. 2021 Feb 19;16(2):e0246467. doi: 10.1371/journal.pone.0246467. eCollection 2021.
BACKGROUND
This research advances understanding of interrelationships among three barriers to adherence to antiretroviral therapy (ART) among pregnant women living with HIV (WLWH) in Cameroon: probable common mental disorders (CMD), intimate partner violence (IPV), and hunger.
METHODS
The sample included 220 pregnant WLWH in Cameroon. Multivariable modified Poisson regression was conducted to assess the relationship between IPV, hunger, and CMD on ART adherence.
RESULTS
Almost half (44%) of participants recently missed/mistimed an ART dose. Probable CMD was associated with greater risk of missed/mistimed ART dose (aRR 1.5 [95% CI 1.1, 1.9]). Hunger was associated with greater risk of missed/mistimed ART dose among those who reported IPV (aRR 1.9 [95% CI 1.2, 2.8]), but not among those who did not (aRR 0.8 [95% CI 0.2, 2.3]).
CONCLUSION
Suboptimal ART adherence, CMD, and IPV were common among pregnant WLWH in Cameroon. Pregnant WLWH experiencing IPV and hunger may be especially vulnerable to suboptimal ART adherence.
背景
本研究增进了对喀麦隆 HIV 阳性孕妇（WLWH）在接受抗逆转录病毒治疗（ART）时面临的三个障碍（可能存在的常见精神障碍（CMD）、亲密伴侣暴力（IPV）和饥饿）之间相互关系的理解。
方法
该样本包括喀麦隆的 220 名孕妇 WLWH。采用多变量修正泊松回归来评估 IPV、饥饿和 CMD 与 ART 依从性之间的关系。
结果
近一半（44%）的参与者最近漏服/错服了一剂 ART。可能存在的 CMD 与漏服/错服 ART 剂量的风险增加相关（ARR 1.5 [95% CI 1.1, 1.9]）。对于报告有 IPV 的参与者，饥饿与漏服/错服 ART 剂量的风险增加相关（ARR 1.9 [95% CI 1.2, 2.8]），但对于没有报告 IPV 的参与者则不然（ARR 0.8 [95% CI 0.2, 2.3]）。
结论
喀麦隆的孕妇 WLWH 中，ART 依从性差、CMD 和 IPV 很常见。经历 IPV 和饥饿的孕妇 WLWH 可能特别容易出现 ART 依从性差的情况。
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