Tekle Asrat, Tsegaye Arega, Ketema Tsige
Jimma University, College of Natural Sciences, Department of Biology, Jimma, Ethiopia.
Patient Prefer Adherence. 2024 Mar 5;18:543-554. doi: 10.2147/PPA.S445164. eCollection 2024.
The scaling-up of antiretroviral therapy (ART) is the greatest accomplishment to reduce the burden of acquired immunodeficiency syndromes (AIDS) to date. However, it requires optimal adherence to be effective. Thus, this study was designed to assess the level of adherence of people living with HIV (PLWH) to ART and its determinants in one of the hardest-hit areas with HIV in Ethiopia.
A health facility-based cross-sectional study design was conducted among adult PLWH, age >18 years, and receiving ART in southwest Ethiopia. Data was collected by face-to-face interviews following the Self-Rating Scale Item for drug adherence and from participants' medical cards. The effects of variables related to socio-demographic and socio-economic factors, disease and medication, health facilities, and patients' behavior on ART adherence were analyzed using a binary logistic regression model. The data was analyzed using R software.
Self-reported good adherence to ART recorded in this study was 73.1% (n =301/412). The risk of poor adherence was significantly higher among those who were divorced, merchants, used ART for longer durationsand were found in stage IV WHO pathogenesis. Contrarily, those who had a positive perception of the effectiveness of ART had significantly better adherence to ART. Longer duration on ART and frequency of pills taken, ≥3 pills per day, were significantly associated with a low CD4 cell count (<500 cells/mm). For each unit increase in medication frequency per day, the likelihood of having a high viral load of >1000 copies/mL was 5.35 times higher.
The ART adherence documented in this study was graded as moderately low. Some variables, such as clinical, medical, and behavioral, were found to affect the adherence of people living with HIV to ART. Hence, care providers should be aware of such variables in the process of treatment, follow-up, and monitoring of people living with HIV in the study area.
扩大抗逆转录病毒疗法（ART）是迄今为止减轻获得性免疫缺陷综合征（AIDS）负担的最大成就。然而，它需要最佳的依从性才能有效。因此，本研究旨在评估埃塞俄比亚艾滋病疫情最严重地区之一的艾滋病毒感染者（PLWH）对抗逆转录病毒疗法的依从水平及其决定因素。
在埃塞俄比亚西南部对年龄大于18岁且正在接受抗逆转录病毒疗法的成年艾滋病毒感染者进行了一项基于医疗机构的横断面研究设计。通过遵循药物依从性自评量表项目进行面对面访谈并从参与者的医疗卡中收集数据。使用二元逻辑回归模型分析与社会人口统计学和社会经济因素、疾病和药物治疗、医疗机构以及患者行为相关的变量对抗逆转录病毒疗法依从性的影响。使用R软件对数据进行分析。
本研究中自我报告的对抗逆转录病毒疗法的良好依从率为73.1%（n = 301/412）。离婚者、商人、使用抗逆转录病毒疗法时间较长且处于世界卫生组织发病机制IV期的人群中，依从性差的风险显著更高。相反，对抗逆转录病毒疗法有效性有积极认知的人群对抗逆转录病毒疗法的依从性明显更好。接受抗逆转录病毒疗法的时间较长以及每天服药次数≥3次与低CD4细胞计数（<500个细胞/mm）显著相关。每天药物服用频率每增加一个单位，病毒载量>1000拷贝/mL的可能性高5.35倍。
本研究记录的抗逆转录病毒疗法依从性被评为中等偏低。发现一些变量，如临床、医疗和行为变量，会影响艾滋病毒感染者对抗逆转录病毒疗法的依从性。因此，在研究区域对艾滋病毒感染者进行治疗、随访和监测的过程中，护理人员应了解这些变量。
