Dos Santos Fabiana Cristina, Batey D Scott, Kay Emma S, Jia Haomiao, Wood Olivia R, Abua Joseph A, Olender Susan A, Schnall Rebecca
Columbia University, School of Nursing, New York, NY 10032, United States.
Tulane University, School of Social Work, New Orleans, LA 70112, United States.
J Am Med Inform Assoc. 2025 Mar 1;32(3):510-517. doi: 10.1093/jamia/ocae322.
To identify demographic, social, and clinical factors associated with HIV self-management and evaluate whether the CHAMPS intervention is associated with changes in an individual's HIV self-management.
This study was a secondary data analysis from a randomized controlled trial evaluating the effects of the CHAMPS, a mHealth intervention with community health worker sessions, on HIV self-management in New York City (NYC) and Birmingham. Group comparisons and linear regression analyses identified demographic, social, and clinical factors associated with HIV self-management. We calculated interactions between groups (CHAMPS intervention and standard of care) over time (6 and 12 months) following the baseline observation, indicating a difference in the outcome scores from baseline to each time across groups.
Our findings indicate that missing medical appointments, uncertainty about accessing care, and lack of adherence to antiretroviral therapy are associated with lower HIV self-management. For the NYC site, the CHAMPS showed a statistically significant positive effect on daily HIV self-management (estimate = 0.149, SE = 0.069, 95% CI [0.018 to 0.289]). However, no significant effects were observed for social support or the chronic nature of HIV self-management. At the Birmingham site, the CHAMPS did not yield statistically significant effects on HIV self-management outcomes.
Our study suggests that CHAMPS intervention enhances daily self-management activities for people with HIV at the NYC site, indicating a promising improvement in routine HIV care.
Further research is necessary to explore how various factors influence HIV self-management over time across different regions.
确定与艾滋病病毒自我管理相关的人口统计学、社会和临床因素，并评估“CHAMPS干预措施”是否与个体艾滋病病毒自我管理的变化相关。
本研究是一项对随机对照试验的二次数据分析，该试验评估了“CHAMPS”（一种结合社区卫生工作者培训的移动医疗干预措施）对纽约市和伯明翰市艾滋病病毒自我管理的效果。通过组间比较和线性回归分析确定与艾滋病病毒自我管理相关的人口统计学、社会和临床因素。我们计算了基线观察后6个月和12个月时两组（CHAMPS干预组和标准治疗组）之间的交互作用，这表明两组从基线到每次观察时结果得分存在差异。
我们的研究结果表明，错过医疗预约、获取医疗服务的不确定性以及对抗逆转录病毒疗法的依从性差与较低的艾滋病病毒自我管理水平相关。对于纽约市的研究点，CHAMPS对艾滋病病毒日常自我管理显示出具有统计学意义的积极效果（估计值=0.149，标准误=0.069，95%置信区间[0.018至0.289]）。然而，在社会支持或艾滋病病毒自我管理的慢性特征方面未观察到显著效果。在伯明翰市研究点，CHAMPS对艾滋病病毒自我管理结果未产生统计学意义上的显著效果。
我们的研究表明，CHAMPS干预措施可增强纽约市研究点艾滋病病毒感染者的日常自我管理活动，这表明在常规艾滋病护理方面有望得到改善。
有必要进一步研究，以探讨不同地区各种因素如何随时间影响艾滋病病毒自我管理。
