评估艾滋病毒支持小组对非洲队列研究中抗逆转录病毒治疗依从性和病毒抑制的影响。
Assessing the impact of HIV support groups on antiretroviral therapy adherence and viral suppression in the African cohort study.
机构信息
U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
HJF Medical Research International, Abuja, Nigeria.
出版信息
BMC Infect Dis. 2021 Jul 20;21(1):694. doi: 10.1186/s12879-021-06390-3.
BACKGROUND
Support groups for people living with HIV (PLWH) may improve HIV care adherence and outcomes. We assessed the impact of support group attendance on antiretroviral therapy (ART) adherence and viral suppression in four African countries.
METHODS
The ongoing African Cohort Study (AFRICOS) enrolls participants at 12 clinics in Kenya, Uganda, Tanzania, and Nigeria. Self-reported attendance of any support group meetings, self-reported ART adherence, and HIV RNA are assessed every 6 months. Logistic regression models with generalized estimating equations were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for support group attendance and other factors potentially associated with ART adherence and viral suppression.
RESULTS
From January 2013 to December 1, 2019, 1959 ART-experienced PLWH were enrolled and 320 (16.3%) reported any support group attendance prior to enrollment. Complete ART adherence, with no missed doses in the last 30 days, was reported by 87.8% while 92.4% had viral suppression <1000copies/mL across all available visits. There was no association between support group attendance and ART adherence in unadjusted (OR 1.01, 95% CI 0.99-1.03) or adjusted analyses (aOR 1.00, 95% CI 0.98-1.02). Compared to PLWH who did not report support group attendance, those who did had similar odds of viral suppression in unadjusted (OR 0.99, 95% CI 0.978-1.01) and adjusted analyses (aOR 0.99, 95% CI 0.97-1.01).
CONCLUSION
Support group attendance was not associated with significantly improved ART adherence or viral suppression, although low support group uptake may have limited our ability to detect a statistically significant impact.
背景
为感染艾滋病毒（HIV）的人提供支持小组可能会改善 HIV 护理的依从性和结果。我们评估了参加支持小组对四个非洲国家抗逆转录病毒治疗（ART）依从性和病毒抑制的影响。
方法
正在进行的非洲队列研究（AFRICOS）在肯尼亚、乌干达、坦桑尼亚和尼日利亚的 12 个诊所招募参与者。每 6 个月评估一次任何支持小组会议的自我报告出席情况、自我报告的 ART 依从性和 HIV RNA。使用广义估计方程的逻辑回归模型来估计支持小组出席情况和其他可能与 ART 依从性和病毒抑制相关的因素的调整比值比（aOR）和 95%置信区间（95%CI）。
结果
从 2013 年 1 月至 2019 年 12 月 1 日，共招募了 1959 名有 ART 经验的 PLWH，其中 320 名（16.3%）在入组前报告参加了任何支持小组。在所有可获得的就诊中，87.8%的人报告完全遵守了 ART，即 30 天内没有漏服一剂，92.4%的人病毒载量<1000 拷贝/mL。在未调整分析（OR 1.01，95%CI 0.99-1.03）或调整分析（aOR 1.00，95%CI 0.98-1.02）中，支持小组出席情况与 ART 依从性之间均无关联。与未报告参加支持小组的 PLWH 相比，未报告参加支持小组的 PLWH 在未调整（OR 0.99，95%CI 0.978-1.01）和调整分析（aOR 0.99，95%CI 0.97-1.01）中，病毒抑制的可能性相似。
结论
支持小组的出席情况与 ART 依从性或病毒抑制的显著改善无关，尽管支持小组的参与率较低可能限制了我们检测统计学显著影响的能力。
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