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手机利用对增强 HIV 感染者服药依从性咨询干预效果的影响。

The effect of mobile phone utilization for enhanced adherence counselling intervention among persons with HIV.

机构信息

College of Medical Sciences, Gombe State University/ Federal Teaching Hospital Gombe, Gombe, Nigeria.

Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria.

出版信息

AIDS Care. 2023 Dec;35(12):1919-1927. doi: 10.1080/09540121.2023.2175771. Epub 2023 Feb 13.

Abstract

The conduct of physical enhanced adherence counselling (EAC) for antiretroviral therapy (ART) non-adherers is often flawed by objectionable time lag from commencement to timely completion of the process. Therefore, we conducted a retrospective cohort study of 342 adults (≥18 years) with HIV on ART to determine the outcome of utilizing mobile phone based EAC intervention. Structural equation modelling framework, with full information maximum likelihood estimator was used to elucidate the pathways linking the relationship between individual characteristics, perceived barriers to ART adherence, and the applied interventions. A total of 321(93.9%) participants completed the required 3 EAC sessions over 60-days. The proportion of viral load (VL) re-suppression (<1000 copies/mL) after EAC intervention was 66.6%. The mean durations of EAC onset from time of high VL confirmation and completion of EAC were 6.26 ± 3.22 and 59.99 ± 5.14 days, respectively. In the simultaneous model (Comparative Fit Index = 0.89, Tucker-Lewis Index = 0.851, Root Mean Square (RMS) Error of Approximation = 0.049, Standardized RMS Residual = 0.059), the variables: forgot, knowledge/beliefs, side effect of drugs, lost/ran out of drugs, scheduling, and stigma were significant barrier factors contributing to poor ART adherence. The use of mobile phones for EAC intervention was effective for early initiation and timely completion of the sessions.

摘要

对接受抗逆转录病毒疗法(ART)但不依从的患者进行体能增强依从性咨询(EAC)的做法常常存在缺陷,即从开始到及时完成整个过程之间存在令人不快的时间滞后。因此,我们对 342 名接受 ART 治疗的成年 HIV 感染者(≥18 岁)进行了回顾性队列研究,以确定利用基于移动电话的 EAC 干预的结果。我们使用结构方程模型框架和完全信息极大似然估计器来阐明个体特征、ART 依从性障碍感知与应用干预之间关系的途径。共有 321 名(93.9%)参与者在 60 天内完成了 3 次 EAC 会话的要求。EAC 干预后病毒载量(VL)再抑制(<1000 拷贝/ml)的比例为 66.6%。EAC 干预开始时从高 VL 确认到完成 EAC 的时间分别为 6.26±3.22 天和 59.99±5.14 天。在同时模型中(比较拟合指数=0.89,塔克-刘易斯指数=0.851,均方根误差逼近=0.049,标准化均方根残差=0.059),忘记、知识/信念、药物副作用、药物丢失/用完、安排和耻辱感等变量是导致 ART 依从性差的显著障碍因素。使用移动电话进行 EAC 干预可有效实现早期启动和及时完成会话。

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