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抑郁和人际支持对 HIV 感染者抗逆转录病毒治疗依从性的影响。

Influence of depression and interpersonal support on adherence to antiretroviral therapy among people living with HIV.

机构信息

Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA.

Department of Community Health and Health Behavior, University of Buffalo, Buffalo, NY, USA.

出版信息

AIDS Res Ther. 2023 Jun 29;20(1):42. doi: 10.1186/s12981-023-00538-8.


DOI:10.1186/s12981-023-00538-8
PMID:37386514
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10308781/
Abstract

BACKGROUND: Poor adherence and under-utilization of antiretroviral therapy (ART) services have been major setbacks to achieving 95-95-95 policy goals in Sub-Saharan Africa. Social support and mental health challenges may serve as barriers to accessing and adhering to ART but are under-studied in low-income countries. The purpose of this study was to examine the association of interpersonal support and depression scores with adherence to ART among persons living with HIV (PLWH) in the Volta region of Ghana. METHODS: We conducted a cross-sectional survey among 181 PLWH 18 years or older who receive care at an ART clinic between November 2021 and March 2022. The questionnaire included a 6-item simplified ART adherence scale, the 20-item Center for Epidemiologic Studies Depression Scale (CES-D), and the 12-item Interpersonal Support Evaluation List-12 (ISEL-12). We first used a chi-squared or Fisher's exact test to assess the association between these and additional demographic variables with ART adherence status. We then built a stepwise multivariable logistic regression model to explain ART adherence. RESULTS: ART adherence was 34%. The threshold for depression was met by 23% of participants, but it was not significantly associated with adherence in multivariate analysis(p = 0.25). High social support was reported by 48.1%, and associated with adherence (p = 0.033, aOR = 3.45, 95% CI = 1.09-5.88). Other factors associated with adherence included in the multivariable model included not disclosing HIV status (p = 0.044, aOR = 2.17, 95% CI = 1.03-4.54) and not living in an urban area (p = 0.00037, aOR = 0.24, 95% CI = 0.11-0.52). CONCLUSION: Interpersonal support, rural residence, and not disclosing HIV status were independent predictors of adherence to ART in the study area.

摘要

背景:在撒哈拉以南非洲,抗逆转录病毒疗法(ART)服务的依从性差和利用率低是实现 95-95-95 政策目标的主要障碍。社会支持和心理健康挑战可能成为获得和坚持接受 ART 治疗的障碍,但在低收入国家研究不足。本研究旨在探讨人际支持和抑郁评分与加纳沃尔特地区接受 HIV 治疗的患者(PLWH)对 ART 的依从性之间的关系。

方法:我们对 2021 年 11 月至 2022 年 3 月期间在一家 ART 诊所接受护理的 181 名 18 岁或以上的 PLWH 进行了横断面调查。问卷包括一个 6 项简化的 ART 依从性量表、20 项流行病学研究中心抑郁量表(CES-D)和 12 项人际支持评估清单-12(ISEL-12)。我们首先使用卡方检验或 Fisher 精确检验评估这些变量与 ART 依从性状态之间的关联,以及其他人口统计学变量。然后,我们构建了一个逐步多变量逻辑回归模型来解释 ART 依从性。

结果:ART 依从性为 34%。23%的参与者达到了抑郁的阈值,但在多变量分析中与依从性无显著关联(p=0.25)。48.1%的人报告了较高的社会支持,与依从性相关(p=0.033,优势比 OR=3.45,95%置信区间 CI=1.09-5.88)。多变量模型中与依从性相关的其他因素包括未披露 HIV 状态(p=0.044,优势比 OR=2.17,95%置信区间 CI=1.03-4.54)和未居住在城市地区(p=0.00037,优势比 OR=0.24,95%置信区间 CI=0.11-0.52)。

结论:在研究区域,人际支持、农村居住和不披露 HIV 状态是 ART 依从性的独立预测因素。

相似文献

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引用本文的文献

[1]
Depressive symptoms and its determinants among people living with HIV in Africa: systematic review and meta-analysis.

BMC Psychiatry. 2025-4-2

[2]
Hotspots and Trends in Research on Mental Health of the Rural Elderly: A Bibliometric Analysis Using CiteSpace.

Healthcare (Basel). 2025-1-21

[3]
Correlates of internalized stigma and antiretroviral therapy adherence among people living with HIV in the Volta region of Ghana.

BMC Public Health. 2025-1-27

[4]
A Conditional Indirect Effects Analysis of Intimate Partner Violence, Depression, Social Support, and Race With Alcohol Consumption among Postpartum Mothers.

J Interpers Violence. 2024-12-18

[5]
Impact of COVID-19 on people living with HIV and HIV care: A qualitative study in the Volta Region of Ghana.

PLOS Glob Public Health. 2024-3-15

[6]
Psychometric and Circumplex Properties Evaluation of the International Personality Item Pool-Interpersonal Circumplex (IPIP-IPC) in Chinese People Living with HIV (PLWH).

Psychol Res Behav Manag. 2024-2-22

[7]
Predictors of HIV status disclosure among people living with HIV (PLHIV) in Ghana: the disclosure conundrum and its policy implications in resource limited settings.

AIDS Res Ther. 2023-11-27

[8]
The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis.

EClinicalMedicine. 2023-10-5

本文引用的文献

[1]
Water Access and Adherence Intention Among HIV-Positive Pregnant Women and New Mothers Receiving Antiretroviral Therapy in Zambia.

Front Public Health. 2022-4-1

[2]
Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021.

HIV AIDS (Auckl). 2022-3-14

[3]
Evaluation of Multiple Imputation with Large Proportions of Missing Data: How Much Is Too Much?

Iran J Public Health. 2021-7

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Global mental health and HIV care: gaps and research priorities.

J Int AIDS Soc. 2021-6

[5]
Examining the relationship between interpersonal support and retention in HIV care among HIV+ nursing mothers in Uganda.

BMC Res Notes. 2021-6-3

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Selecting the model for multiple imputation of missing data: Just use an IC!

Stat Med. 2021-5-10

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Illness perceptions, social support and antiretroviral medication adherence in people living with HIV in the greater Accra region, Ghana.

Nurs Open. 2021-9

[8]
Monitoring HIV infection in Minas Gerais state: 15-year assessment of adults living with HIV initiating Antiretroviral Therapy.

Rev Soc Bras Med Trop. 2020-12-11

[9]
The Relationship Between Counseling and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Enrolled in Option B.

AIDS Educ Prev. 2020-10

[10]
Resilience, self-esteem, self-efficacy, social support, depression and ART adherence among people living with HIV in Sichuan, China.

AIDS Care. 2021-11

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