Seleman K. Semvua, Kilimanjaro Christian Medical University College, Moshi, Tanzania;, Email:
Christine Yaeree Kim, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States, and Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Am J Health Behav. 2022 Apr 20;46(2):124-133. doi: 10.5993/AJHB.46.2.3.
In this study, we explored determinants of "researcher-observed" patient-initiated antiretroviral therapy (ART) repackaging practices among people living with HIV (PLHIV) in Northern Tanzania. We used a quasi-experimental design to describe the prevalence of ART self- repackaging; we conducted face-to-face surveys to determine factors associated with ART self- repackaging practices. Data collection sites included the Kilimanjaro Christian Medical Centre and the Mawenzi Referral Hospital. We used study-specific numerical identifiers assigned to ARTs packaging to determine self-repackaging behavior. Self-repackaging was defined as a binary variable where participants who discarded antiretroviral drugs packaging in at least 2 clinic visits were classified as self- repackagers. We used multivariable logistic regression to assess the determinants of patient-initiated repackaging practices. Among 590 study participants, 57.6% self-repackaged based on researcher observation and 55.6% self-repackaged based on patient report. Researcher-observed self- repackaging was associated with gender (AOR = 1.590; 95% CI: 1.011, 2.502), employment status (AOR = 0.475: 95% CI; 0.239, 0.942), and study site (AOR = 0.218; 95% CI: 0.134, 0.355). A substantial proportion of patients self-repackage their ARTs for various reasons. Health system interventions should focus on addressing the attributes of repackaging among men and unemployed patients.
在这项研究中，我们探讨了坦桑尼亚北部艾滋病毒感染者（PLHIV）中“研究人员观察到的”患者发起的抗逆转录病毒疗法（ART）重新包装实践的决定因素。我们使用准实验设计来描述 ART 自我重新包装的流行率；我们进行面对面调查以确定与 ART 自我重新包装实践相关的因素。数据收集地点包括乞力马扎罗基督教医学中心和曼文尼转诊医院。我们使用特定于研究的编号标识符来确定 ART 包装的自我重新包装行为。自我重新包装被定义为一个二进制变量，其中在至少 2 次就诊中丢弃抗逆转录病毒药物包装的参与者被归类为自我重新包装者。我们使用多变量逻辑回归来评估患者发起的重新包装实践的决定因素。在 590 名研究参与者中，根据研究人员的观察，有 57.6%的人自我重新包装，根据患者报告，有 55.6%的人自我重新包装。研究人员观察到的自我重新包装与性别（AOR=1.590；95%CI：1.011，2.502）、就业状况（AOR=0.475：95%CI；0.239，0.942）和研究地点（AOR=0.218；95%CI：0.134，0.355）有关。相当一部分患者出于各种原因自行重新包装他们的 ARTs。卫生系统干预措施应侧重于解决男性和失业患者重新包装的属性。
