Lai Hsin-Hao, Wang Chien-Chun, Yen Tsen-Fang, Yeh Po-Tsen, Yen Yung-Feng, Hsu Su-Han
Section of Infectious disease, Yangming Branch, Taipei City Hospital, Taipei, Taiwan.
School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan.
J Epidemiol Glob Health. 2024 Dec;14(4):1701-1710. doi: 10.1007/s44197-024-00329-y. Epub 2024 Nov 25.
Adherence to Highly Active Antiretroviral Therapy (HAART) is critical in controlling HIV. Poor medication adherence may lead to higher disease mortality, increased HIV spread, and transmission of drug-resistant strains. Identifying the specific factors that contribute to suboptimal medication adherence in people with HIV is crucial for developing effective, personalized interventions.
This study conducted a cross-sectional analysis by enrolling individuals over 18 years of age with HIV at a single clinic in Taipei, Taiwan, from December 2018 to November 2020. Participants completed a questionnaire that collected demographic data, recreational drug use, comorbidities, and history of sexually transmitted infections (STIs). The Medication Adherence Report Scale (MARS-5) was utilized to assess treatment adherence. A multiple logistic regression model was applied to identify the factors influencing adherence.
A total of 831 PWH were included in the analysis. After controlling for demographics, comorbidities, and recreational drug use, independent risk factors associated with poor adherence among PWH include the presence of a depressive disorder (AOR:2·887, 95% CI:1·461-5·703, p = 0·002), a history of acquired gonorrhea (AOR:2·026, 95% CI:1·079 - 3·803, p = 0·028), methamphetamine use within past three months (AOR:2·073, 95% CI:1·172-3·665, p = 0·012), HIV-1 RNA ≥ 40 copies/ml (AOR:5·221, 95% CI:2·976-9·157, p < 0·001) and younger age (AOR:0·959, 95% CI:0·932-0·988, p = 0·006).
To enhance HIV treatment adherence, targeted efforts are essential for PWH who are young, have used methamphetamine in the past three months, are experiencing depressive disorders, or have previously acquired gonorrhea.
坚持高效抗逆转录病毒疗法（HAART）对于控制艾滋病病毒（HIV）至关重要。药物依从性差可能导致更高的疾病死亡率、HIV传播增加以及耐药菌株的传播。识别导致HIV感染者药物依从性欠佳的具体因素对于制定有效的个性化干预措施至关重要。
本研究于2018年12月至2020年11月在台湾台北的一家诊所对18岁以上的HIV感染者进行了横断面分析。参与者完成了一份问卷，收集了人口统计学数据、娱乐性药物使用情况、合并症以及性传播感染（STIs）病史。采用药物依从性报告量表（MARS-5）评估治疗依从性。应用多元逻辑回归模型确定影响依从性的因素。
共有831名HIV感染者纳入分析。在控制了人口统计学、合并症和娱乐性药物使用情况后，与HIV感染者依从性差相关的独立危险因素包括存在抑郁症（调整后比值比[AOR]：2.887，95%置信区间[CI]：1.461 - 5.703，p = 0.002）、获得性淋病病史（AOR：2.026，95% CI：1.079 - 3.803，p = 0.028）、过去三个月内使用甲基苯丙胺（AOR：2.073，95% CI：1.172 - 3.665，p = 0.012）、HIV-1 RNA≥40拷贝/毫升（AOR：5.
