Habumugisha Emmanuel, Nyishimirente Sylvie, Katende Godfrey, Nkurunziza Aimable, Mukeshimana Madeleine, Ngerageze Innocent, Mukashyaka Joella
University of Rwanda, College of Medicine and Health Sciences, School of Nursing and Midwifery, Kigali, Rwanda.
New York University, Rory Meyer College of Nursing, New York, USA.
Rwanda J Med Health Sci. 2022 Dec 20;5(3):251-263. doi: 10.4314/rjmhs.v5i3.1. eCollection 2022 Dec.
HIV continues to be an important public health concern among adolescents. To reduce the high rate of mortality and improve the quality of life among people with HIV, WHO guidelines emphasize the early initiation of ART drugs in HIV-infected persons regardless of their CD4 count and clinical status. However, adherence to ART remains low in adolescents between 10 to 19 years from low and middle-income countries (LMICs).
To determine the factors influencing adherence to ART among adolescents with HIV in Rwanda.
A cross-sectional design using proportional stratified random sampling to select 166 adolescents was conducted. Data were analyzed using descriptive and inferential statistics with a p-value <0.05 and a CI of 95%.
The overall adherence to ARTs was 38%. Assistance of clinical staff in taking medication (p<0.001) and the help of parents in taking medication (p<0.001) positively influenced adherence to ART. Insufficient health care providers, forgetfulness (p=0.009), and dosage too complex (p=0.044) negatively influenced adherence to ART.
Factors such as some one reminding adolescents to take medication, non-stigmatization, and absence of side effects were positively associated with ART adherence. On the other hand, forgetfulness, complex dosage, being isolated and inadequate education about medications negatively affect adherence to ARTs. There is a need to set strategies to increase adherence to ARTs, including expert clients and trustable guardians in care provision. All adolescents should receive adequate counselling and health education before the initiation of ARTs.
艾滋病病毒(HIV)仍是青少年群体中一个重要的公共卫生问题。为降低HIV感染者的高死亡率并提高其生活质量,世界卫生组织(WHO)的指南强调,无论HIV感染者的CD4细胞计数和临床状况如何,都应尽早开始抗逆转录病毒治疗(ART)药物。然而,来自低收入和中等收入国家(LMICs)的10至19岁青少年对抗逆转录病毒治疗的依从性仍然很低。
确定影响卢旺达青少年HIV感染者抗逆转录病毒治疗依从性的因素。
采用比例分层随机抽样进行横断面设计,选取了166名青少年。使用描述性和推断性统计方法对数据进行分析,p值<0.05,置信区间为95%。
抗逆转录病毒治疗的总体依从率为38%。临床工作人员协助服药(p<0.001)和父母协助服药(p<0.001)对抗逆转录病毒治疗的依从性有积极影响。医疗保健提供者不足、健忘(p=0.009)和剂量过于复杂(p=0.044)对抗逆转录病毒治疗的依从性有负面影响。
有人提醒青少年服药、无污名化以及无副作用等因素与抗逆转录病毒治疗的依从性呈正相关。另一方面,健忘、剂量复杂、被孤立以及对药物的教育不足会对抗逆转录病毒治疗的依从性产生负面影响。有必要制定提高抗逆转录病毒治疗依从性的策略,包括在护理服务中引入专业患者和可信赖的监护人。所有青少年在开始抗逆转录病毒治疗前都应接受充分的咨询和健康教育。