影响亚马逊地区艾滋病毒/艾滋病感染者抗逆转录病毒治疗依从性的因素。

Factors influencing adherence to anti-retroviral therapy in amazonian indigenous people living with HIV/AIDS.

机构信息

Centro Nacional de Salud Intercultural, Instituto Nacional de Salud Lima, Perú.

Dirección Regional de Salud Amazonas, Chachapoyas, Perú.

出版信息

BMC Public Health. 2023 Mar 15;23(1):497. doi: 10.1186/s12889-023-15362-y.

DOI:10.1186/s12889-023-15362-y

PMID:36922774

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10015934/

Abstract

BACKGROUND

Indigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from Awajun and Wampis indigenous communities, living with HIV-AIDS in a Peruvian Amazonian region.

METHODS

A cross-sectional study was completed with a consecutive sample of people from indigenous communities (Awajun or Wampis) living with HIV, who were receiving antiretroviral treatment for at least the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces in the Amazonian region. An ad-hoc questionnaire was used to collect information about demographic, economic, and socio-cultural factors and access to health services. The Simplified Medication Adherence Questionnaire (SMAQ) was used to evaluate adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise was performed to explore factors that might influence adherence.

RESULTS

Of the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15-3.02), economic income (aPR: 0.64; 95%CI 0.41-0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18-0.70) were related to complete adherence to medication.

CONCLUSION

Only a third of participants reported complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to the therapeutic scheme. Interventions to improve adherence in indigenous people living with HIV should consider these factors in order to develop effective implementation strategies.

摘要

背景

秘鲁的土著社区历史上一直受到艾滋病毒/艾滋病感染导致的高死亡率的影响，这与获得卫生服务的机会有限以及社会文化障碍有关。在这种情况下，本研究旨在描述与生活在秘鲁亚马逊地区的 Awajun 和 Wampis 土著社区的艾滋病毒感染者的抗逆转录病毒治疗依从性相关的因素。

方法

这是一项横断面研究，采用连续样本，包括至少在过去三个月内接受抗逆转录病毒治疗的艾滋病毒感染者。参与者于 2021 年 10 月 1 日至 12 月 30 日期间从亚马逊地区的 Bagua 和 Condorcanqui 两省的四个区招募。使用专门的问卷收集有关人口统计学、经济和社会文化因素以及获得卫生服务的信息。使用简化药物依从性问卷（SMAQ）评估抗逆转录病毒治疗的依从性。采用向后逐步的多变量逻辑回归分析来探讨可能影响依从性的因素。

结果

在 208 名参与者中，28.8%报告完全依从抗逆转录病毒治疗。多变量逻辑回归显示，职业（调整后的比值比[aPR]：1.86；95%置信区间 [CI]：1.15-3.02）、经济收入（aPR：0.64；95%CI：0.41-0.99）和抗逆转录病毒治疗的不良反应（aPR：0.36；95%CI：0.18-0.70）与完全依从药物治疗有关。