合理选择艾滋病母婴传播阻断抗病毒治疗方案的影响因素  

Factors affecting rational selection of antiretroviral therapy regimens in prevention of mother-to-child transmission of HIV/AIDS

作　　者：汪永忠[1] 李燕[1] 杨育燕 罗希莹[1] 蒋成芹 章永[4] 熊玉华 罗开敏 

机构地区：[1]昆明医学院公共卫生学院,云南昆明650031 [2]陇川县妇幼保健院,云南陇川678700 [3]潞西市妇幼保健院,云南潞西678400 [4]腾冲县妇幼保健院,云南腾冲679100 [5]瑞丽市妇幼保健院,云南瑞丽678600 [6]临翔区妇幼保健院,云南临沧677000

出　　处：《中国艾滋病性病》2008年第6期566-568,575,共4页Chinese Journal of Aids & STD

基　　金：国家科技攻关计划课题(编号:2004BA719A14-7),研究生科研经费

摘　　要：目的探索艾滋病母婴传播阻断中,合理选择抗病毒治疗方案的主要影响因素,为制定艾滋病病毒(HIV)感染孕妇及其所生婴儿的抗病毒治疗合理用药提供依据。方法在云南省5个全面开展了母婴传播阻断、且妇幼保健网络相对健全的艾滋病高、中度流行县(市、区),对抗病毒治疗合理选择方案的影响因素进行病例对照研究和定性调查。结果对158例HIV感染孕产妇进行问卷调查,并对15名管理医生、24名HIV感染孕产妇及其家属进行个人深入访谈。定量与定性研究发现,抗病毒治疗方案合理选择的主要相关因素为:产次顺序(OR=3.135)、少数民族(OR=3.393)、未知情选择(OR=5.745)、方案是医生要求的(OR=0.329)、为了孩子不被感染的愿望、医生对方案的认识等。结论多个因素对HIV感染孕产妇合理选择抗病毒治疗方案有影响,在方案选择时要针对主要影响因素开展工作。Objective To understand main factors affecting rational selection of antiretroviral therapy （ARVT） regimens in preention of mother-to-child transmission （PMTCT） of HIV/AIDS, providing basis for developing strategy of using rational ARVT regimen for HIV positive pregnant women and their infants. Methods Qualitative and quantitative methods to measure the rational selection of ARVT regimens for PMTCT were used in a case-control study of mothers who received services of PMTCT from Janury of 2005 to June of 2007 in 5 HIV epidemic counties, where incidence of HIV/AIDS was higher, the work of PMTCT were developed in a comprehensive way and local MCH networks were established in general. Results A total of 158 mothers were interviewed by questionnaire surveys, and 15 medical workers working for PMTCT, 24 infected mothers with their husbands were also interviewed personally. The quantitative and qual- itative study indicated that the key factors affecting rational selection of ARVT regimens included ： times of delivery （ OR = 3.135） ,ethnics （OR=3. 393 ）, selection without informed consent （OR = 5. 745 ）, decision by medical workers alone （ OR=0. 329）,mothers＇ wishes to prevent infants from being infected and awareness of the medical workers of ARVT regimen. Conclusions Multiple factors affect the rational selection of ARVT regimens and the mains affecting factors should be considered in selecting appropriate regimens.

关 键 词：艾滋病病毒 孕产妇 抗病毒治疗 合理用药 影响因素 

分 类 号：R512.91[医药卫生—内科学]