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评估 HIV 病例管理干预措施及其与接受抗逆转录病毒治疗的 HIV 阳性成年人的 cART 依从性和疾病状况披露的关联。

Evaluation of the interventions on HIV case management and its association with cART adherence and disclosure of the disease status among HIV-positive adults under treatment.

机构信息

Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

Sci Rep. 2022 Aug 12;12(1):13729. doi: 10.1038/s41598-022-17905-6.

Abstract

The rate of prevalence of HIV among adults has been increasing in sub-Saharan African countries over the last decade. The objective of this study was to evaluate the interventions on HIV case management based on cART adherence and disclosure of HIV disease status among HIV-positive adults under treatment. A retrospective cohort longitudinal data was conducted on 792 randomly selected patients in the study area. Engagement of HIV-positive persons into care and achieving treatment outcomes such as the disclosure of HIV status and cART adherence were fundamental for HIV prevention strategy. The two response variables under the current investigation were evaluation of intervention on HIV case management interims cART adherence and disclosure of HIV status. Binary logistic regression was conducted for separate models. Among the predictors, age of patients (AOR = 1.020, 95% CI (1.016, 1.191); p value = 0.005), the number of follow-up (AOR = 1.014, 95% CI (1.023, 1.030); p value < 0.0001). CD4 cell count (AOR = 0.981; 95% CI (0.765, 0.971), p value < 0.01), Marital status (AOR = 1.013; 95% CI (1.002, 1.015), p value = 0.006), female patients (AOR = 1.014; 95% CI (1.001, 1.121), p value < 0.007), rural (AOR = 0.982; 95% CI (0.665, 0.998), p value = 0.004), non-educated adult patients (AOR = 0.950, 95% CI (0.92. 0.98). p value = 0.003), Non-existence of social violence (AOR = 1.012, 95% CI (1.008, 1.234), p value < 0.01), adult with non-opportunistic diseases (AOR = 1.021, 95% CI (1.002. 1.042). p value = 0.001) significantly affected the two response variables jointly. Interventions on HIV case management lead to an efficient continuum of successful treatment outcomes like disclosure of HIV status and cART adherence. Hence, HIV case management intervention and the two results had a positive association. HIV case management intervention should be given to younger patients, rural residents, and non-educated patients to disclose the disease status and to have a long life with the virus. Health-related education should be conducted for the community in general and for patients in particular on how HIV is transferred from an infected person to an uninfected one. This helps to reduce the stigma of patients and to deliver social support to patients.

摘要

撒哈拉以南非洲国家成年人中艾滋病毒流行率在过去十年呈上升趋势。本研究的目的是评估基于 cART 依从性和艾滋病毒阳性成人治疗中艾滋病毒疾病状况披露的艾滋病毒病例管理干预措施。对研究区域内随机选择的 792 名患者进行了回顾性队列纵向数据分析。艾滋病毒感染者参与护理并实现艾滋病毒状况披露和 cART 依从等治疗结果,是艾滋病毒预防策略的基础。当前调查的两个因变量是对艾滋病毒病例管理干预措施的评估、cART 依从性和艾滋病毒状况披露的中期评估。对单独的模型进行了二元逻辑回归。在预测因素中,患者年龄(AOR=1.020,95%CI(1.016,1.191);p 值=0.005)、随访次数(AOR=1.014,95%CI(1.023,1.030);p 值<0.0001)。CD4 细胞计数(AOR=0.981;95%CI(0.765,0.971),p 值<0.01)、婚姻状况(AOR=1.013;95%CI(1.002,1.015),p 值=0.006)、女性患者(AOR=1.014;95%CI(1.001,1.121),p 值<0.007)、农村(AOR=0.982;95%CI(0.665,0.998),p 值=0.004)、非受教育成年患者(AOR=0.950,95%CI(0.92.0.98)。p 值=0.003)、无社会暴力(AOR=1.012,95%CI(1.008,1.234),p 值<0.01)、非机会性疾病成人(AOR=1.021,95%CI(1.002.1.042)。p 值=0.001)共同显著影响两个因变量。艾滋病毒病例管理干预措施导致艾滋病毒状况披露和 cART 依从等成功治疗结果的有效连续。因此,艾滋病毒病例管理干预措施和这两个结果之间存在正相关关系。应向年轻患者、农村居民和非受教育患者提供艾滋病毒病例管理干预措施,以披露疾病状况,并与病毒长期共存。应向一般社区和特别是患者开展有关艾滋病毒如何从感染者传播到未感染者的健康知识教育。这有助于减少患者的耻辱感,并为患者提供社会支持。

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