乌干达西南部农村地区 15-24 岁青少年的 HIV 护理保留率及相关因素。
Retention in HIV care and associated factors among youths aged 15-24 years in rural southwestern Uganda.
机构信息
Mbarara University of Science and Technology, Faculty of Medicine, Mbarara, Uganda.
Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
出版信息
BMC Public Health. 2021 Jul 31;21(1):1489. doi: 10.1186/s12889-021-11547-5.
BACKGROUND
Retention in HIV care contributes to antiretroviral therapy adherence, which is a key factor for improved treatment outcomes and prevention of drug resistance. However, HIV treatment among the youths is characterized by loss to follow up, poor adherence to ART, risk of treatment failure and high mortality rates compared to young children and adults. There is limited information about factors associated with retention of youths in HIV care in rural settings in Uganda. We aimed to determine retention in HIV care and associated factors among youths aged 15-24 years in rural southwestern Uganda.
METHODS
A cross-sectional study was conducted among youths aged 15-24 years who were receiving care at the HIV clinic at Kabuyanda HC IV who had been in care for at least 1 year before the study. We used an interviewer-administered questionnaire to collect socio-demographic information. Participant chart abstraction was used to collect information on HIV clinic attendance. We collected information on HIV related stigma using the 40-item Berger Stigma Scale. Chi-square test and multivariable logistic regression analysis were used to determine the factors associated with retention in HIV care with a significance level of < 0.05. Retention in HIV care was, defined as having sought care at least once per quarter in the 12 months prior to the study.
RESULTS
We enrolled 102 participants with a mean age of 20.95 (SD ± 3.07) years. Two thirds (65.7%) of the youths had been retained in HIV care in the previous 12 months. In adjusted analyses, being male, married and had perinatally acquired HIV were independently associated with retention in HIV care. The association between HIV related stigma and retention in HIV care was not statistically significant.
CONCLUSION
Retaining adolescents and young adults in HIV care in rural southwestern Uganda is still much lower than the WHO target of 90%. Being male, having perinatally acquired HIV and married or in a relationship are associated with retention in HIV care. Interventions targeting adolescents and young adults living with HIV are necessary to improve retention in HIV care to the WHO target of 90%.
背景
艾滋病病毒（HIV）护理中的保留率有助于抗逆转录病毒治疗（ART）的依从性，这是改善治疗效果和预防耐药性的关键因素。然而，与幼儿和成年人相比，HIV 治疗在年轻人中表现为失访、ART 依从性差、治疗失败风险高和死亡率高。在乌干达农村地区，关于与年轻人保留在 HIV 护理中相关的因素知之甚少。我们旨在确定在乌干达西南部农村地区，15-24 岁的年轻人保留在 HIV 护理中的情况，并确定相关因素。
方法
对在 Kabuyanda HC IV 的 HIV 诊所接受护理、在研究前至少接受了 1 年护理的 15-24 岁年轻人进行了一项横断面研究。我们使用访谈者管理的问卷收集社会人口统计学信息。通过参与者图表摘录收集 HIV 诊所就诊信息。我们使用 40 项 Berger 耻辱量表收集与 HIV 相关耻辱的信息。使用卡方检验和多变量逻辑回归分析确定与 HIV 护理保留相关的因素，显著性水平为<0.05。HIV 护理保留定义为在研究前 12 个月内至少每季度寻求过一次护理。
结果
我们共纳入 102 名参与者，平均年龄为 20.95（标准差±3.07）岁。三分之二（65.7%）的年轻人在过去 12 个月内保留了 HIV 护理。在调整后的分析中，男性、已婚和母婴传播的 HIV 是与 HIV 护理保留相关的独立因素。HIV 相关耻辱与 HIV 护理保留之间的关联没有统计学意义。
结论
在乌干达西南部农村地区，保留青少年和年轻人的 HIV 护理仍然远低于世界卫生组织（WHO）的 90%目标。男性、母婴传播的 HIV 和已婚或有伴侣关系与 HIV 护理保留相关。有必要针对 HIV 感染者中的青少年和年轻人开展干预措施，以提高 HIV 护理保留率，达到 WHO 的 90%目标。
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