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艾滋病病毒/艾滋病感染者抗逆转录病毒治疗的依从性:一项横断面研究。

Adherence to Antiretroviral Therapy in People Living with HIV/AIDS: A Cross-Sectional Study.

机构信息

Department of Nursing and Universidade Federal de São Carlos, São Carlos, SP, Brazil.

Postgraduate Nursing Program, Universidade Federal de São Carlos, São Carlos, SP, Brazil.

出版信息

AIDS Patient Care STDS. 2022 Jul;36(7):278-284. doi: 10.1089/apc.2022.0056.

Abstract

Adherence to antiretroviral therapy (ART) is essential to suppress HIV replication, preserve immune competence, and ensure quality of life for people living with HIV/AIDS. This is a cross-sectional study to assess adherence to ART in HIV-infected adults and its associated factors in São Carlos, SP, Brazil, from June 2018 to January 2019. Standardized interviews were conducted covering demographic, clinical, and laboratory characteristics and instruments to assess compliance to treatment (CEAT-VIH), HIV/AIDS-targeted quality of life (HAT-QoL), and self-efficacy expectations of adherence (SEA-ART). Each variable was analyzed for association with adherence to ART, by refilling at least 90% of the prescribed doses in the 6 months before the interview date. The study consisted of 220 participants, with a mean age of 43 years, 60.5% male, and 24.5% men who have sex with men. Previous consumption of alcohol or illicit drugs was reported by 44.1% of participants and current or previous smoking by 34.1%. The most common regimen was two nucleoside reverse transcriptase inhibitors combined with one non-nucleoside reverse transcriptase inhibitor (37.3%). The adherence to ART was 62%, and the factors associated with it were living alone [adjusted odds ratio (aOR) 2.79], not having an active sexual life (aOR 0.43), not being a smoker (aOR 0.36), having a CD4 count ≥350 cells/mm (aOR 2.50), and having a SEA-ART Score >100 (aOR 1.94). The fear of disclosing HIV status could make adherence to treatment difficult. This could be the reason that living alone and not having an active sexual life have been associated with better adherence. Encouraging healthy lifestyle habits and promoting self-efficacy tools can also improve adherence.

摘要

抗逆转录病毒疗法(ART)的依从性对于抑制 HIV 复制、保持免疫功能和确保 HIV/AIDS 患者的生活质量至关重要。这是一项横断面研究,旨在评估巴西圣卡塔琳娜州圣卡洛斯市 HIV 感染成年人的 ART 依从性及其相关因素,研究时间为 2018 年 6 月至 2019 年 1 月。通过标准化访谈涵盖人口统计学、临床和实验室特征以及评估治疗依从性的工具(CEAT-VIH)、针对 HIV/AIDS 的生活质量(HAT-QoL)和对依从性的自我效能期望(SEA-ART)。每个变量均根据在访谈日期前 6 个月内至少补充了 90%规定剂量的情况进行分析,以评估其与 ART 依从性的相关性。该研究共纳入 220 名参与者,平均年龄为 43 岁,60.5%为男性,24.5%为男男性接触者。44.1%的参与者报告曾使用过酒精或非法药物,34.1%的参与者当前或曾经吸烟。最常见的方案是两种核苷逆转录酶抑制剂联合一种非核苷逆转录酶抑制剂(37.3%)。ART 的依从性为 62%,与依从性相关的因素包括独居(调整后的优势比[aOR]为 2.79)、没有活跃的性生活(aOR 为 0.43)、不吸烟(aOR 为 0.36)、CD4 计数≥350 个细胞/mm(aOR 为 2.50)和 SEA-ART 评分>100(aOR 为 1.94)。对 HIV 状况披露的恐惧可能会使治疗依从性变得困难。这可能是独居和没有活跃性生活与更好的依从性相关的原因。鼓励健康的生活方式习惯和促进自我效能工具也可以提高依从性。

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