Mostashari F, Riley E, Selwyn P A, Altice F L
Yale University AIDS Program, New Haven, Connecticut 06510-2483, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Aug 1;18(4):341-8. doi: 10.1097/00042560-199808010-00005.
We examined attitudinal and demographic correlates of antiretroviral acceptance and adherence among incarcerated HIV-infected women. Structured interviews were conducted with 102 HIV-infected female prisoners eligible for antiretroviral therapy. Three quarters of the women were currently taking antiretroviral agents, of whom 62% were adherent to therapy. Satisfaction was very high with the HIV care offered at the prison; 67% had been first offered antiretroviral agents while in prison. Univariate and multivariate analyses showed acceptance of the first offer of antiretroviral therapy to be associated with trust in medication safety, lower educational level, and non-black race. Current acceptance of therapy was associated with trust in the medication's efficacy and safety. Medication adherence was correlated with the patient-physician relationship and presence of emotional supports. Nearly one half of these HIV-seropositive women were willing to take experimental HIV medications in prison. This was correlated with satisfaction with existing health care, the presence of HIV-related social supports, and perceived susceptibility to a worsening condition. Acceptance and adherence with antiretroviral agents appear to be significantly associated with trust in medications, trust in the health care system, and interpersonal relationships with physicians and peers. Development of models of care that encourage and support such relationships is essential for improving adherence to antiretroviral therapy, especially for populations that have historically been marginalized from mainstream medical care systems.
我们研究了被监禁的感染艾滋病毒女性对抗逆转录病毒药物的接受度和依从性与态度及人口统计学因素之间的关联。对102名符合抗逆转录病毒治疗条件的感染艾滋病毒的女性囚犯进行了结构化访谈。四分之三的女性目前正在服用抗逆转录病毒药物，其中62%的人坚持治疗。对监狱提供的艾滋病毒护理满意度非常高；67%的人在狱中首次获得抗逆转录病毒药物。单变量和多变量分析表明，接受首次抗逆转录病毒治疗与对药物安全性的信任、较低的教育水平和非黑人种族有关。目前对治疗的接受与对药物疗效和安全性的信任有关。药物依从性与医患关系和情感支持的存在相关。这些艾滋病毒血清阳性女性中近一半愿意在狱中服用实验性艾滋病毒药物。这与对现有医疗保健的满意度、艾滋病毒相关社会支持的存在以及对病情恶化的感知易感性相关。对抗逆转录病毒药物的接受度和依从性似乎与对药物的信任、对医疗保健系统的信任以及与医生和同伴的人际关系显著相关。开发鼓励和支持这种关系的护理模式对于提高抗逆转录病毒治疗的依从性至关重要，特别是对于那些历史上被主流医疗保健系统边缘化的人群。
