College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Republic of Korea; Department of Pharmacy, Inha University Hospital, Incheon, Republic of Korea.
College of Medicine, Inha University, Incheon, Republic of Korea.
J Infect Public Health. 2023 Oct;16(10):1598-1605. doi: 10.1016/j.jiph.2023.07.018. Epub 2023 Jul 29.
The number of people with HIV/AIDS has consistently increased in Korea since the first case of HIV/AIDS infection was reported in 1985. The depressive symptoms of patients with HIV/AIDS may lead to medication non-adherence. This study sought to investigate the cross-sectional and longitudinal association between depression and antiretroviral treatment adherence in the Korean HIV/AIDS population.
We included participants of the Korea HIV/AIDS cohort study between 2009 and 2017. All information was collected at the enrollment and every annual visit, including sociodemographic characteristics, health-related behaviors, HIV/AIDS infection-related factors, depression score, and frequency of skipped medication. We performed a cross-sectional analysis of 601 participants registered between 2009 and 2017. Longitudinal data were evaluated by panel regression analysis in 515 patients who registered from 2009 to 2013.
In cross-sectional analysis, the HIV/AIDS patients with depressive symptoms were more likely to be non-adherent (adjusted OR = 0.52, 95 % CI 0.34, 0.79, p = 0.002). Medication adherence was significantly associated with a health-related lifestyle; the adjusted odds ratio of the non-smoking and non-drinking group was 1.75 (95 % CI 1.05, 2.90, p = 0.031). The longitudinal panel regression model revealed a significant negative impact of depression on medication adherence (adjusted OR = 0.50, 95 % CI 0.30, 0.84, p = 0.009). Non-smoking and non-drinking participants were 2.31 times more likely to adhere to antiretroviral treatment (95 % CI 1.29, 4.15, p = 0.005).
Our finding of depression and lifestyle modifications being significant contributors underscore the importance of proactive interventions to optimize the treatment outcomes of PLWH.
自 1985 年首例 HIV/AIDS 感染病例报告以来，韩国的 HIV/AIDS 患者人数持续增加。HIV/AIDS 患者的抑郁症状可能导致药物治疗依从性差。本研究旨在探讨韩国 HIV/AIDS 人群中抑郁与抗逆转录病毒治疗依从性的横断面和纵向关联。
我们纳入了 2009 年至 2017 年期间参加韩国 HIV/AIDS 队列研究的参与者。所有信息均在入组时和每年的就诊时收集，包括社会人口学特征、与健康相关的行为、HIV/AIDS 感染相关因素、抑郁评分和漏服药物的频率。我们对 2009 年至 2017 年期间登记的 601 名参与者进行了横断面分析。对 2009 年至 2013 年期间登记的 515 名患者进行了面板回归分析。
在横断面分析中，有抑郁症状的 HIV/AIDS 患者更有可能不遵医嘱（调整后的 OR = 0.52，95%CI 0.34，0.79，p = 0.002）。药物治疗依从性与健康相关的生活方式显著相关；不吸烟和不饮酒组的调整后比值比为 1.75（95%CI 1.05，2.90，p = 0.031）。纵向面板回归模型显示，抑郁对药物治疗依从性有显著的负面影响（调整后的 OR = 0.50，95%CI 0.30，0.84，p = 0.009）。不吸烟和不饮酒的参与者更有可能坚持抗逆转录病毒治疗，其可能性是 2.31 倍（95%CI 1.29，4.15，p = 0.005）。
我们发现抑郁和生活方式改变是重要的影响因素，这强调了积极干预以优化 PLWH 治疗效果的重要性。
