2019年埃塞俄比亚西北部戈贾姆东区卫生中心接受治疗的人类免疫缺陷病毒阳性患者的抗逆转录病毒治疗依从性及相关因素：基于社区的横断面研究
Adherence to antiretroviral therapy and associated factors among human immunodeficiency -positive patients accessing treatment at health centers in East Gojjam Zone, Northwest Ethiopia, 2019: Community-based cross-sectional study.
作者信息
Tariku Mengistie Kassahun, Worede Daniel Tarekegn, Belete Abebe Habtamu
机构信息
Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
出版信息
Heliyon. 2023 Jul 13;9(7):e18279. doi: 10.1016/j.heliyon.2023.e18279. eCollection 2023 Jul.
BACKGROUND
To achieve an effective treatment outcome, Antiretroviral Therapy (ART) for people living with the Human immunodeficiency virus (HIV) needs at least a 95% adherence level. The aim was to assess adherence to antiretroviral therapy and its associated factors among patients accessing treatment at Health centers in East Gojjam Zone, Northwest Ethiopia.
METHODS
A community-based cross-sectional study was conducted on 770 HIV-positive patients from April 1 to May 10, 2019, in East Gojjam Zone. The study participants were selected by simple random computerized sampling methods. Primary data was collected from the patients through face-to-face interviews and home-to-home visits. Bivariable and multivariable binary logistic regression analyses were done. Independent variables with a P-value of <0.2 in bivariable binary logistic regression analysis were considered for multivariable binary logistic regression analysis. A P-value of <0.05 was used as the cut-off point for the presence of statistical significance.
RESULTS
About 396 (51.8%) of the study participants had good adherence. Being 18-24 years old [Adjusted Odd Ratio (AOR) = 0.43; 95% CI = 0.21-0.86], having a marital status of being widowed (AOR = 0.29; 95% CI = 0.14-0.58), having a disease duration of >10 years (AOR = 0.47; 95% CI = 0.24-0.94), taking a drug regimen of Tenofovir (TDF) + Lamivudine (3 TC) + Nevirapine (NVP) (AOR = 2.94; 95% CI = 1.406.15), not being socially stigmatized (AOR = 0.52; 95% CI = 0.34-0.78), and having not encountered an opportunistic infection (AOR = 3.91; 95% CI = 2.68-5.72) were significant factors
CONCLUSIONS
The level of adherence was low. Opportunistic infection prevention, reduction of social stigma, and other intervention activities should be strengthened to increase the level of adherence.
背景
为实现有效的治疗效果，针对感染人类免疫缺陷病毒（HIV）的人群的抗逆转录病毒疗法（ART）需要至少95%的依从水平。目的是评估埃塞俄比亚西北部东戈贾姆地区卫生中心接受治疗的患者对抗逆转录病毒疗法的依从性及其相关因素。
方法
2019年4月1日至5月10日，在东戈贾姆地区对770名HIV阳性患者进行了一项基于社区的横断面研究。研究参与者通过简单随机计算机抽样方法选取。通过面对面访谈和逐户走访从患者处收集原始数据。进行了双变量和多变量二元逻辑回归分析。双变量二元逻辑回归分析中P值<0.2的自变量被纳入多变量二元逻辑回归分析。P值<0.05被用作具有统计学意义的截断点。
结果
约396名（51.8%）研究参与者具有良好的依从性。年龄在18 - 24岁之间[调整后的优势比（AOR）= 0.43；95%置信区间（CI）= 0.21 - 0.86]、婚姻状况为丧偶（AOR = 0.29；95% CI = 0.14 - 0.58）、病程>10年（AOR = 0.47；95% CI = 0.24 - 0.94）、采用替诺福韦（TDF）+拉米夫定（3TC）+奈韦拉平（NVP）的药物治疗方案（AOR = 2.94；95% CI = 1.40 - 6.15）、未受到社会歧视（AOR = 0.52；95% CI = 0.34 - 0.78）以及未发生机会性感染（AOR = 3.91；95% CI = 2.68 - 5.72）是显著因素。
结论
依从水平较低。应加强机会性感染预防措施、减少社会歧视以及开展其他干预活动以提高依从水平。
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