Jeffe D B, Meredith K L, Mundy L M, Fraser V J
Division of Health Behavior Research, Washington University School of Medicine, St. Louis, Missouri 63108, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Dec 1;19(4):350-60. doi: 10.1097/00042560-199812010-00005.
In 1996, we interviewed 224 HIV-infected patients (54% men, 63% African American) receiving HIV medical care in St. Louis, Missouri about their recognition, prior use, and current use of HIV medications. Of 221 respondents who had heard of at least one antiretroviral drug, only 2 respondents reported they had never taken antiretroviral drugs. Multivariate logistic regression among respondents with CD4 counts <500 cells/mm3 identified sociodemographic variables (gender, race, education, and site of care) that were significantly (p < .05) associated with never having heard of, never having used, and not currently using specific antiretroviral drugs. African Americans in general, African American women, or African Americans with 12 years of schooling were more likely never to have heard of didanosine (ddI)/zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), protease inhibitors, and non-nucleoside reverse transcriptase inhibitors (NNRTIs). In addition, women were more likely never to have heard of protease inhibitors, and respondents with < or = 12 years of schooling were more likely never to have heard of NNRTIs. African Americans were more likely never to have taken azidothymidine (AZT), and African American women were more likely never to have taken 3TC and protease inhibitors. Sociodemographic variables were not significantly associated with current use of specific antiretroviral drugs among those with CD4 levels <500 cells/mm3, nor with recognition, prior use, or current use of Pneumocystis carinii pneumonia prophylaxis among those with CD4 counts <200 cells/mm3. Findings indicate that, even among patients receiving HIV care, African Americans, women, and those with < or = 12 years of schooling were more likely never to have heard of and never to have used various specific antiretroviral medications. More focused efforts are needed to help patients become aware of available antiretroviral drugs and to encourage greater use of these drugs among all patients for whom the drugs are indicated.
1996年，我们对在密苏里州圣路易斯接受HIV医疗护理的224名HIV感染患者（54%为男性，63%为非裔美国人）进行了访谈，了解他们对HIV药物的认知、既往使用情况和当前使用情况。在221名听说过至少一种抗逆转录病毒药物的受访者中，只有2名受访者表示他们从未服用过抗逆转录病毒药物。对CD4细胞计数<500个细胞/mm³的受访者进行多因素逻辑回归分析，确定了社会人口统计学变量（性别、种族、教育程度和护理地点）与从未听说过、从未使用过以及当前未使用特定抗逆转录病毒药物之间存在显著（p<0.05）关联。一般来说，非裔美国人、非裔美国女性或接受过12年学校教育的非裔美国人更有可能从未听说过去羟肌苷（ddI）/扎西他滨（ddC）、司他夫定（d4T）、拉米夫定（3TC）、蛋白酶抑制剂和非核苷类逆转录酶抑制剂（NNRTIs）。此外，女性更有可能从未听说过蛋白酶抑制剂，接受过≤12年学校教育的受访者更有可能从未听说过NNRTIs。非裔美国人更有可能从未服用过齐多夫定（AZT），非裔美国女性更有可能从未服用过3TC和蛋白酶抑制剂。社会人口统计学变量与CD4水平<500个细胞/mm³的患者当前使用特定抗逆转录病毒药物无关，也与CD4细胞计数<200个细胞/mm³的患者对卡氏肺孢子虫肺炎预防的认知、既往使用或当前使用无关。研究结果表明，即使在接受HIV护理的患者中，非裔美国人、女性以及接受过≤12年学校教育的人更有可能从未听说过和从未使用过各种特定的抗逆转录病毒药物。需要做出更有针对性的努力，以帮助患者了解可用的抗逆转录病毒药物，并鼓励所有有指征使用这些药物的患者更多地使用这些药物。
