埃塞俄比亚西北部费莱格希沃特教学与专科医院HIV阳性成年人高效抗逆转录病毒治疗依从性能力的社会人口学、经济和临床预测因素

Socio-Demographic, Economic and Clinical Predictors for HAART Adherence Competence in HIV-Positive Adults at Felege Hiwot Teaching and Specialized Hospital, North West Ethiopia.

作者信息

Tegegne Awoke Seyoum

机构信息

Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

HIV AIDS (Auckl). 2021 Jul 9;13:749-758. doi: 10.2147/HIV.S320170. eCollection 2021.

DOI:10.2147/HIV.S320170

PMID:34267557

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8277417/

Abstract

BACKGROUND

Currently, around 36.7 million people in the world are living with HIV. Among these, 52% are living in sub-Saharan Africa. The main objective of this study was to identify socio-demographic economic and clinical factors associated with HAART adherence competence in successive visits among adult HIV patients after commencement of their treatment.

METHODS

A retrospective cohort study design was conducted on a random sample of 792 treatment attendants. The samples were selected using stratified random samples technique considering their residence area as strata. Secondary data were used in this study. Structural equation modeling (SEM) was applied to identify predictors of HAART adherence competence over time.

RESULTS

In this longitudinal study, factors affecting long-term HAART adherence competence in successive visits were identified. Among the predictors, marital status (mean = 3.97, variance = 0.6, p = 0.021), level of disclosure of the disease (mean = 6.24, variance = 0.29, p = 0.012), residence area (mean = 3.97, variance = 0.6, p = 0.021), level of education (mean = 2.04, variance= 0.81, p = 0.012), ownership of cell phone (mean = 2.99, variance = 0.68, p = 0.034), household income (mean = 6.37, variance = 0.53, p = 0.002), age of patients (mean = -2.78, variance = 56.64, p = 0.023), sex of patients (mean = -1.25, variance = 0.88, p = 0.036), weight (mean = -2.89, 42.36, p = 0.001), initial CD4 cell count (mean = 2.57, variance = 158.48, p = 0.015) and WHO stages (mean = 2.37, variance = 0.78, p = 0.026) were directly associated with retention of medication care. On the other hand, medication care was significantly and independently associated with longitudinal adherence competence.

CONCLUSION

The outcome variable in successive visits increased with the number of follow-up visits, but the rate of increase was different for different groups, such as urban and rural, and for those patients disclosing and not disclosing the disease to family members. An integrated health-related education should be given for non-adherent patients like rural residents, patients living without partners, patients with no cell phone and aged patients.

摘要

背景

目前，全球约有3670万人感染了艾滋病毒。其中，52%生活在撒哈拉以南非洲。本研究的主要目的是确定成年艾滋病毒患者开始治疗后连续就诊时与高效抗逆转录病毒治疗（HAART）依从性能力相关的社会人口、经济和临床因素。

方法

对792名治疗参与者的随机样本进行回顾性队列研究设计。采用分层随机抽样技术，将居住地区作为分层因素来选择样本。本研究使用二手数据。应用结构方程模型（SEM）来确定随时间推移HAART依从性能力的预测因素。

结果

在这项纵向研究中，确定了影响连续就诊时长期HAART依从性能力的因素。在预测因素中，婚姻状况（均值 = 3.97，方差 = 0.6，p = 0.021）、疾病披露程度（均值 = 6.24，方差 = 0.29，p = 0.012）、居住地区（均值 = 3.97，方差 = 0.6，p = 0.021）、教育程度（均值 = 2.04，方差 = 0.81，p = 0.012）、手机拥有情况（均值 = 2.99，方差 = 0.68，p = 0.034）、家庭收入（均值 = 6.37，方差 = 0.53，p = 0.002）、患者年龄（均值 = -2.78，方差 = 56.64，p = 0.023）、患者性别（均值 = -1.25，方差 = 0.88，p = 0.036）、体重（均值 = -2.89，方差 = 42.36，p = 0.001）、初始CD4细胞计数（均值 = 2.57，方差 = 158.48，p = 0.015）和世界卫生组织（WHO）分期（均值 = 2.37，方差 = 0.78，p = 0.026）与药物治疗的持续情况直接相关。另一方面，药物治疗与纵向依从性能力显著且独立相关。