Byansi William, Nabunya Proscovia, Muwanga Joelynn, Mwebembezi Abel, Damulira Christopher, Mukasa Barbara, Zmachinski Lily, Nattabi Jennifer, Brathwaite Rachel, Namuwonge Flavia, Bahar Ozge Sensoy, Neilands Torsten B, Mellins Claude A, Ssewamala Fred M
Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130.
Reach the Youth Uganda.
Z Gesundh Wiss. 2023 Jul;31(7):1177-1184. doi: 10.1007/s10389-021-01632-9. Epub 2021 Jul 9.
Adolescents living with HIV (ALHIV) are at high risk for adherence to antiretroviral (ART) treatment and poor health-seeking behaviors, both of which potentially compromise their quality of and satisfaction with life. This study, therefore, seeks to examine the relationship between physical health, pediatric quality of life, life satisfaction, and medication adherence among ALHIV in southwestern Uganda.
Baseline data from the Suubi+Adherence study, 2012-2018, that recruited 702 adolescents, aged 10-16 years, living with HIV in Uganda were analyzed. To account for overdispersion, negative binomial regression analyses were used to examine the impact of physical health, pediatric quality of life, and life satisfaction on self-reported medication adherence. We controlled for participants' socio-demographic factors.
Results indicated that after adjusting for socio-demographic characteristics, adolescents' reported satisfaction with life was associated with a decrease in the reported number of days missed taking medication by 41.2% (IRR (incidence risk ratio)=0.588; p (p-value)=0.014). On the other hand, the low level of pediatric quality of life was associated with a 5% increase in the reported number of days missed taking medication (IRR=1.055, p=0.044). Personal health was not statistically significant in the model.
Our study findings indicated that quality of life and life satisfaction are significantly associated with antiretroviral (ART) medication among ALHIV. Hence, strengthening existing support systems and creating additional support for optimal ART adherence and treatment outcomes for ALHIV in low-resource communities might be beneficial. Moreover, with the increasing HIV prevalence rates among adolescents, effective and comprehensive efforts that are responsive to the special needs of ALHIV must be developed to ensure optimal adherence to ART medication as it leads to low vertical infection and superinfection rates.
感染艾滋病毒的青少年（ALHIV）坚持抗逆转录病毒（ART）治疗的风险很高，且就医行为不佳，这两者都可能损害他们的生活质量和满意度。因此，本研究旨在探讨乌干达西南部ALHIV的身体健康、儿童生活质量、生活满意度与药物依从性之间的关系。
分析了2012年至2018年Suubi+依从性研究的基线数据，该研究招募了702名年龄在10至16岁之间、生活在乌干达的感染艾滋病毒的青少年。为了应对过度分散的情况，使用负二项回归分析来检验身体健康、儿童生活质量和生活满意度对自我报告的药物依从性的影响。我们控制了参与者的社会人口学因素。
结果表明，在调整社会人口学特征后，青少年报告的生活满意度与报告的漏服药物天数减少41.2%相关（发病率风险比（IRR）=0.588；p值=0.014）。另一方面，儿童生活质量水平低与报告的漏服药物天数增加5%相关（IRR=1.055，p=0.044）。个人健康在模型中无统计学意义。
我们的研究结果表明，生活质量和生活满意度与ALHIV的抗逆转录病毒（ART）药物显著相关。因此，加强现有支持系统，并为资源匮乏社区的ALHIV提供额外支持，以实现最佳的ART依从性和治疗效果，可能会有所帮助。此外，随着青少年中艾滋病毒感染率的不断上升，必须开展有效和全面的努力，以满足ALHIV的特殊需求，确保最佳的ART药物依从性，因为这会降低垂直感染和重复感染率。
