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尼日利亚阿夸伊博姆州接受抗逆转录病毒治疗患者治疗中断的预测因素:12个月后的结果

Predictors of treatment interruption among patients on antiretroviral therapy in Akwa Ibom, Nigeria: outcomes after 12 months.

作者信息

Akpan Uduak, Kakanfo Kunle, Ekele Oche D, Ukpong Kufre, Toyo Otoyo, Nwaokoro Pius, James Ezekiel, Pandey Satish, Olatubosun Kolawole, Bateganya Moses

机构信息

Achieving Health Nigeria Initiative, Akwa Ibom, Nigeria.

FHI 360, Akwa Ibom, Nigeria.

出版信息

AIDS Care. 2023 Jan;35(1):114-122. doi: 10.1080/09540121.2022.2093826. Epub 2022 Jun 28.

Abstract

Understanding the characteristics of people living with HIV who interrupt antiretroviral therapy (ART) is critical for designing client-centered services to ensure optimal outcomes. We assessed predictors of treatment interruption in 22 HIV clinics in Nigeria. We reviewed records of HIV-positive patients aged ≥15 years who started ART 1 January and 31 March 2019. We determined treatment status over 12 months as either active, or interrupted treatment (defined as interruption in treatment up to 28 days or longer). Potential predictors were assessed using Cox hazard regression models. Overall, 1185 patients were enrolled on ART, 829 (70%) were female, and median age was 32 years Retention at 1, 3, 6, 9, and 12 months was 85%, 80%, 76%, 72%, and 68%, respectively. Predictors of treatment interruption were post-secondary education ( = 0.04), diagnosis through voluntary counseling and testing ( < 0.001), receiving care at low-volume facilities ( < 0.001), lack of access to a peer counselor ( < 0.001), and residing outside the clinic catchment area ( = 0.03). Treatment interruption was common but can be improved by focusing on lower volume health facilities, providing peer support especially to those with higher education, and client-centered HIV services for those who live further from clinics..

摘要

了解中断抗逆转录病毒疗法(ART)的艾滋病毒感染者的特征,对于设计以客户为中心的服务以确保最佳结果至关重要。我们评估了尼日利亚22家艾滋病毒诊所治疗中断的预测因素。我们回顾了2019年1月1日至3月31日开始接受抗逆转录病毒治疗的15岁及以上艾滋病毒阳性患者的记录。我们将12个月内的治疗状态确定为持续治疗或中断治疗(定义为治疗中断长达28天或更长时间)。使用Cox风险回归模型评估潜在的预测因素。总体而言,1185名患者开始接受抗逆转录病毒治疗,其中829名(70%)为女性,中位年龄为32岁。1、3、6、9和12个月时的治疗保留率分别为85%、80%、76%、72%和68%。治疗中断的预测因素包括高等教育(=0.04)、通过自愿咨询和检测确诊(<0.001)、在低容量医疗机构接受护理(<0.001)、无法获得同伴咨询(<0.001)以及居住在诊所服务区域之外(=0.03)。治疗中断情况很常见,但可以通过关注低容量医疗机构、为尤其是受过高等教育的人提供同伴支持以及为居住在离诊所较远地区的人提供以客户为中心的艾滋病毒服务来加以改善。

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