影响菲律宾马尼拉艾滋病患者抗逆转录病毒治疗依从性的风险因素:菲律宾“携手生命”研究的基线横断面分析

Risk factors affecting adherence to antiretroviral therapy among HIV patients in Manila, Philippines: a baseline cross-sectional analysis of the Philippines Connect for Life Study.

作者信息

O Connor Cara, Leyritana Katerina, Calica Kris, Gill Randeep, Doyle Aoife M, Lewis James J, Salvaña Edsel Maurice

机构信息

Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines; and London School of Hygiene and Tropical Medicine, London, UK; and Wits Reproductive Health and HIV Research Institute, Johannesburg, South Africa; and Corresponding author. Email:

Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines.

出版信息

Sex Health. 2021 Mar;18(1):95-103. doi: 10.1071/SH20028.

Abstract

UNLABELLED

Background The Philippines HIV epidemic is one of the fastest growing, globally. Infections among men who have sex with men (MSM) are rising at an alarming rate, necessitating targeted evidence-based interventions to reach epidemic control. Treatment as prevention is a key strategy to end AIDS, making it a priority to explore novel approaches to retain people living with HIV (PLHIV) in care, support adherence, and reach viral suppression.

METHODS

This cross-sectional analysis describes HIV-related risk behaviours and adherence to antiretroviral therapy (ART) in a population of HIV-positive patients at a clinic in Metro Manila, Philippines participating in the Philippines Connect for LifeTM cohort study.

RESULTS

Among 426 HIV-positive adults taking ART, 79% reported ≥95% adherence over the prior 30 days. Longer time on treatment was associated with reduced adherence to ART (adjusted odds ratio (AOR) = 0.87 per year, P = 0.027). Being in a serodiscordant relationship, in which the subject's primary partner was HIV negative, increased adherence (AOR = 3.19, P = 0.006). Inconsistent condom use (AOR = 0.50, P = 0.103) and injection drug use (AOR = 0.54, P = 0.090) are potentially associated with reduced adherence to ART. Patients used drugs and alcohol at significantly higher rates than the general population.?

CONCLUSIONS

The study found that patients in this setting require intervention to address treatment fatigue. Interventions to improve social support of PLHIV, as well as harm-reduction approaches for drug and alcohol use, could improve adherence in this population, strengthening the test-and-treat strategy to control the epidemic.

摘要

未标注

背景 菲律宾的艾滋病疫情是全球增长最快的之一。男男性行为者(MSM)中的感染率正以惊人的速度上升,因此需要有针对性的循证干预措施来实现疫情控制。治疗即预防是终结艾滋病的关键策略,因此探索新方法以留住艾滋病毒感染者(PLHIV)接受治疗、支持其坚持治疗并实现病毒抑制成为当务之急。

方法

本横断面分析描述了菲律宾马尼拉大都会一家诊所参与菲律宾生命连接队列研究的艾滋病毒阳性患者群体中与艾滋病毒相关的风险行为及对抗逆转录病毒疗法(ART)的依从性。

结果

在426名接受抗逆转录病毒治疗的艾滋病毒阳性成年人中,79%报告在过去30天内依从性≥95%。治疗时间越长,对抗逆转录病毒疗法的依从性越低(调整后的优势比[AOR]=每年0.87,P=0.027)。处于血清学不一致关系中(即受试者的主要伴侣为艾滋病毒阴性)会提高依从性(AOR=3.19,P=0.006)。不坚持使用避孕套(AOR=0.50,P=0.103)和注射吸毒(AOR=0.54,P=0.090)可能与抗逆转录病毒疗法依从性降低有关。患者使用毒品和酒精的比例明显高于普通人群。

结论

研究发现,该环境下的患者需要干预以解决治疗疲劳问题。改善对艾滋病毒感染者的社会支持的干预措施,以及针对毒品和酒精使用的减少危害方法,可提高该人群的依从性,加强检测和治疗策略以控制疫情。

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