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在 COVID-19 时代,埃塞俄比亚中部艾滋病毒感染者对艾滋病抗病毒药物的坚持情况及其对大流行的感知影响。

Adherence to Antiretroviral Medications Among People Living With HIV in the Era of COVID-19 in Central Ethiopia and Perceived Impact of the Pandemic.

机构信息

Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Department of Neurology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

出版信息

Community Health Equity Res Policy. 2023 Oct;44(1):99-107. doi: 10.1177/0272684X221094151. Epub 2022 Aug 9.

Abstract

AIM

This study assessed the level of adherence to antiretroviral drugs and the associated factors among clients who have a follow-up at public health facilities in central Ethiopia.

METHOD

A multi-site cross-sectional study was conducted from August 1-30, 2020 at seven public health institutions. A systematic random sampling method was used to recruit 385 participants. Data was collected using a structured interviewer-administered questionnaire. Analysis was done using descriptive statistics, and binary logistic regression model. The OR with its 95% C.I was employed to present analytic outputs. Statistical significance for the multivariable model was considered at ≤ 0.05.

RESULTS

Of the 371 participants, the majority were females (233, 62.8%), attended health centers (215, 58.0%), and were married (173, 46.6%). Eighty-nine (89, 24.0%) of the participants have at least one comorbidity. About 72 (19.0%) and 50 (13.5%) of the respondents stated that the COVID-19 has posed challenges on their follow-ups and availability of medications respectively. Nearly a half of the people living with HIV and comorbid T2DM or hypertension (29, 48.0%) reported that they had encountered an increase in the price of medications compared to the pre-COVID-19 times. About half of the respondents in the study setting have perfect adherence to antiretroviral therapy (ART) (200, 54.0%). Basic education (aOR = 3.02: 95% CI: 1.57-5.80), marriage (aOR = 2.27: 95% CI: 1.24-4.15), attendance to a health center (aOR = 0.59: 95% CI: 0.36-0.98) and sleep disturbance (aOR = 0.47: 95% CI: 0.26-0.84) showed a statistically significant association with adherence to ART.

CONCLUSION

About half of the respondents in the study settings have perfect adherence to their ART medications. As multiple factors interplay in the success rate of adherence to ART, stakeholders should place and strengthen practices, such as active follow-up and tracing of cases, ensuring medication affordability (access and low pricing), and psycho-social support to patients.

摘要

目的

本研究评估了在埃塞俄比亚中部公共卫生机构接受随访的患者抗逆转录病毒药物的依从性水平及其相关因素。

方法

2020 年 8 月 1 日至 30 日,在 7 家公共卫生机构进行了多地点横断面研究。采用系统随机抽样方法招募了 385 名参与者。使用结构化访谈员管理的问卷收集数据。采用描述性统计和二元逻辑回归模型进行分析。采用比值比(OR)及其 95%置信区间(CI)表示分析结果。多变量模型的统计学显著性水平设定为 ≤ 0.05。

结果

在 371 名参与者中,大多数为女性(233 名,62.8%),在卫生中心就诊(215 名,58.0%),已婚(173 名,46.6%)。89 名(89 名,24.0%)的参与者至少有一种合并症。约 72 名(19.0%)和 50 名(13.5%)的受访者表示,COVID-19 对他们的随访和药物供应造成了挑战。近一半患有 HIV 并伴有 2 型糖尿病或高血压的人(29 名,48.0%)报告说,与 COVID-19 之前相比,药物价格有所上涨。在研究环境中,约有一半的受访者(200 名,54.0%)对抗逆转录病毒治疗(ART)有完全的依从性。基础教育(OR = 3.02;95%CI:1.57-5.80)、已婚(OR = 2.27;95%CI:1.24-4.15)、到卫生中心就诊(OR = 0.59;95%CI:0.36-0.98)和睡眠障碍(OR = 0.47;95%CI:0.26-0.84)与 ART 的依从性呈统计学显著关联。

结论

在研究环境中,约有一半的受访者对其 ART 药物有完全的依从性。由于多种因素共同作用于 ART 依从率,利益相关者应采取并加强实践,如积极随访和追踪病例、确保药物可负担性(可及性和低价)以及为患者提供心理社会支持。

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