Rodríguez-Díaz Carlos E, Zangeneh Sahar Z, Chen Yumei O, Guo Xu, Tsuyuki Kiyomi, Ransome Yusuf, Friedman Ruth K, Srithanaviboonchai Kriengkrai, Roberts Sarah T, Mimiaga Matthew J, Mayer Kenneth H, Safren Steven A
Boston University School of Public Health.
RTI International, Durham, North Carolina; School of Public Health, University of Washington.
AIDS Educ Prev. 2025 Apr;37(2):89-106. doi: 10.1521/aeap.2025.37.2.89.
In the field of HIV prevention and care, most studies of HIV syndemic problems are cross-sectional, few differentiate by HIV transmission groups, and few focus on people living with HIV (PWH). We analyzed one-year longitudinal data of 692 sexually active PWH (heterosexual men [HM], heterosexual women [HW], and men who have sex with men [MSM]) in care from Brazil, Thailand, and Zambia. Syndemic scores (0-3+) included stimulant use, polydrug use, depression, alcohol use, and fear of discrimination. Overall, syndemic scores were associated with lower ART adherence over time, but this differed across sexual transmission categories. For HM and HW, those with 2 or 3+ syndemic problems had lower odds of ART adherence than those with none. However, for MSM, the association between syndemic scores and ART adherence was not significant. While syndemic problems generally predicted suboptimal ART adherence among PWH, the association appears nuanced across subgroups.
在艾滋病毒预防和护理领域，大多数关于艾滋病毒综合征问题的研究都是横断面研究，很少按艾滋病毒传播群体进行区分，也很少关注艾滋病毒感染者（PWH）。我们分析了来自巴西、泰国和赞比亚接受护理的692名性活跃的艾滋病毒感染者（异性恋男性[HM]、异性恋女性[HW]和男男性行为者[MSM]）的一年纵向数据。综合征评分（0-3+）包括使用兴奋剂、使用多种药物、抑郁、饮酒和对歧视的恐惧。总体而言，随着时间的推移，综合征评分与抗逆转录病毒治疗依从性较低有关，但这在不同性传播类别中有所不同。对于异性恋男性和异性恋女性，有2个或3个以上综合征问题的人坚持抗逆转录病毒治疗的几率低于没有这些问题的人。然而，对于男男性行为者，综合征评分与抗逆转录病毒治疗依从性之间的关联并不显著。虽然综合征问题通常预示着艾滋病毒感染者的抗逆转录病毒治疗依从性不理想，但这种关联在亚组之间似乎存在细微差别。
