Jackson F. Doe Memorial Regional Referral Hospital, (MOH), Tappita, Liberia.
Faculty of Public Health, Mahidol University, 420/1 Ratchawithee Road, Rajthewee, Bangkok, 10400, Thailand.
AIDS Res Ther. 2022 Jun 25;19(1):27. doi: 10.1186/s12981-022-00455-2.
It has been widely noted that lifetime adherence to antiretroviral therapy (ART) is necessary for HIV treatment outcome; however, retention on ART among people living with HIV (PLWH) remains a great challenge to achieve the Global AIDS Strategy: End inequalities, End AIDS. Nonadherence to ART is one of the HIV care problem in Liberia despite the availability of free ART. Psychosocial factors, i.e., perceived stigma and social support likely contributed to nonadherence to ART. We investigated associations among clinical factors, psychosocial factors, and nonadherence to ART.
A community-based cross-sectional study was conducted among 185 PLWH, age ≥ 18 years receiving ART in Ganta, Nimba county, Liberia at least 3 months. The structured questionnaire was used to collect data from April to May 2020. Associated factors of nonadherence to ART were identified using multivariable binary logistic regression, and the p-value < 0.05 was considered statistically significant.
Of 185 respondents, 62.2% showed nonadherence to ART. Females reported higher nonadherence compared with males (64.4% vs. 56.6%). Multivariable binary logistic regression revealed strong experiences of stigma (PORadj = 2.392, p-value = 0.018), poor information support (PORadj = 2.102, p-value = 0.026) increased prevalence of ART nonadherence among Liberian PLWH.
The healthcare providers may apply interventions to reduce perceived stigma and to enhance continuous information provision in addition to support from health care providers and family members. An intensive monitoring of ART side effects is needed to be strengthened in particular among newly started ART patients.
人们普遍认识到，终身坚持抗逆转录病毒疗法（ART）是实现 HIV 治疗效果所必需的；然而，艾滋病毒感染者（PLWH）坚持接受抗逆转录病毒治疗仍然是实现全球艾滋病战略的一大挑战：终结不平等，终结艾滋病。尽管免费提供抗逆转录病毒治疗，但在利比里亚，不遵守抗逆转录病毒治疗仍然是艾滋病毒护理问题之一。心理社会因素，即感知到的耻辱感和社会支持，可能导致不遵守抗逆转录病毒治疗。我们调查了临床因素、心理社会因素与不遵守抗逆转录病毒治疗之间的关联。
在利比里亚宁巴县甘塔，我们对至少接受了 3 个月抗逆转录病毒治疗的 185 名年龄≥18 岁的 PLWH 进行了一项基于社区的横断面研究。我们使用结构化问卷从 2020 年 4 月至 5 月收集数据。使用多变量二项逻辑回归识别与不遵守抗逆转录病毒治疗相关的因素，p 值<0.05 被认为具有统计学意义。
在 185 名受访者中，有 62.2%的人不遵守抗逆转录病毒治疗。与男性相比，女性报告的不遵守率更高（64.4%比 56.6%）。多变量二项逻辑回归显示，强烈的耻辱感经历（调整后优势比[PORadj] = 2.392，p 值 = 0.018）和较差的信息支持（PORadj = 2.102，p 值 = 0.026）增加了利比里亚 PLWH 不遵守抗逆转录病毒治疗的发生率。
医疗保健提供者可以采取干预措施，减少感知到的耻辱感，并加强持续的信息提供，此外还需要得到医疗保健提供者和家庭成员的支持。需要加强对抗逆转录病毒治疗副作用的强化监测，特别是在新开始接受抗逆转录病毒治疗的患者中。
