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乌干达军队管理的医疗机构中接受治疗的艾滋病毒感染者在强化依从性咨询后实现艾滋病毒病毒载量抑制。

HIV viral load suppression following intensive adherence counseling among people living with HIV on treatment at military-managed health facilities in Uganda.

作者信息

Kikaire Bernard, Ssemanda Michael, Asiimwe Alex, Nakanwagi Miriam, Rwegyema Twaha, Seruwagi Gloria, Lawoko Stephen, Asiimwe Evarlyne, Wamundu Cassette, Musinguzi Ambrose, Lugada Eric, Turesson Elizabeth, Laverentz Marni, Bwayo Denis

机构信息

Makerere University College of Health Sciences, Kampala, Uganda.

University Research Co., LLC, Department of Defense HIV/AIDS Prevention Program (DHAPP), Kampala, Uganda.

出版信息

Int J Infect Dis. 2021 Nov;112:45-51. doi: 10.1016/j.ijid.2021.08.057. Epub 2021 Sep 2.

DOI:10.1016/j.ijid.2021.08.057

PMID:34481969

Abstract

BACKGROUND

Uniformed service personnel have an increased risk of poor viral load suppression (VLS). This study was performed to evaluate the outcomes of interventions to improve VLS in the 28 military health facilities in Uganda.

METHODS

This operational research was conducted between October 2018 and September 2019, among people living with HIV (PLHIV) in the 28 health facilities managed by the military in Uganda. Patients with a viral load (VL) >1000 copies/ml received three sessions of intensive adherence counselling (IAC), 1 month apart, after which a repeat VL was done. The main outcome was the proportion with a suppressed VL following IAC.

RESULTS

Of the 965 participants included in this analysis, 592 (61.4%) were male and 367 (38.3%) were female. Average age was 35.5 ± 13.7 years, and 87.8% had at least one IAC session. At least 48.2% had a suppressed repeat VL. IAC increased the odds of VLS by 82% (P = 0.004), with adjusted OR of 1.56 (P = 0.054). An initial VL >10 000 copies/ml, being on antiretroviral therapy for at least 2 years, being male, and being <18 years of age were associated with repeat VL non-suppression.

CONCLUSIONS

IAC marginally improved VL suppression. There is a need to improve IAC in military health facilities.

摘要

背景

军队服务人员病毒载量抑制不佳（VLS）的风险增加。本研究旨在评估乌干达28家军事卫生机构中改善VLS的干预措施的效果。

方法

这项操作性研究于2018年10月至2019年9月在乌干达军队管理的28家卫生机构中的艾滋病毒感染者（PLHIV）中进行。病毒载量（VL）>1000拷贝/毫升的患者接受了3次强化依从性咨询（IAC），每次间隔1个月，之后进行重复VL检测。主要结果是IAC后病毒载量得到抑制的比例。

结果

纳入本次分析的965名参与者中，592名（61.4%）为男性，367名（38.3%）为女性。平均年龄为35.5±13.7岁，87.8%的人至少接受过一次IAC咨询。至少48.2%的人重复检测时病毒载量得到抑制。IAC使VLS的几率增加了82%（P = 0.004），调整后的比值比为1.56（P = 0.054）。初始VL>10000拷贝/毫升、接受抗逆转录病毒治疗至少2年、男性以及年龄<18岁与重复VL未得到抑制有关。