高流行地区预防艾滋病母婴传播规律用药及影响因素分析  

Analysis on regular medicating and influencing factors for prevention mother-infant transmission of HIV/AIDS in highly prevalent areas

作　　者：武红萍[1] 郑佳瑞[2] 杨海霞[2] 吕汝华 

机构地区：[1]云南省建水县妇幼保健院,654311 [2]云南省妇幼保健院

出　　处：《中国妇幼保健》2013年第8期1313-1316,共4页Maternal and Child Health Care of China

基　　金：国家"十一五"科技重大专项〔2009zx10004-902〕

摘　　要：目的:全面了解云南省艾滋病高流行县(市、区)HIV阳性孕产妇孕期服抗病毒药情况及影响因素,为相关卫生主管部门今后促进HIV阳性孕妇孕期规范服药提供科学依据。方法:采用流行病学病例对照研究方法,收集13个高流行县(市、区)的HIV阳性孕产妇孕期服抗病毒药的相关资料。结果:13个县(市、区)共调查了HIV阳性并选择继续妊娠的孕产妇314人,规律服药率为93.3%。对孕期规律服药的影响因素中,对母婴阻断的信心越强服药越规律,与其他服药方案相比AZT+3TC+LPV/r、AZT+3TC+EFV和AZT+3TC+NVP 3种方案更容易规律服药,对生与不生孩子选择的困难程度越大服药越不规律,对预防艾滋病母婴传播知识的了解程度越高服药越规律,敌对情绪越高服药越不规律,对以后孩子的照顾越担心服药越不规律。结论:影响HIV感染孕产妇规律服药的影响因素较一般HIV感染者复杂得多。建议结合产前保健服务,根据患者的具体情况,建立个性化服务和随访方式;加强医患沟通,建立信任关系,优化服药方案。Objective ： To understand taking antiviral drugs situation and influencing factors of HIV - positive pregnant women, to provide a scientific evidence for the relevant health authorities in order to promote HIV - positive pregnant women medicating situation during pregnancy in future. Methods ： Using epidemiological case - control study, relevant information of HIV - positive pregnant women for taking antiviral drugs in 13 high HIV prevalence counties （cities, districts） of Yunnan province were collected. Results： A total of 314 pregnant women of HIV - positive, came from 13 districts, who choose to continue pregnancy were investigated. The regnlar medicating was 93.3%. In the influence factors of regular medicating, the more stronger confidence of prevention mother - infant transmission HIV, the more regular medicating. Three kinds of medicating scheme, AZT ＋ 3TC ＋ LPV/r, AZT ＋ 3TC ＋ EFV and AZT ＋ 3TC ＋ NVP, were easier to regular medication, compared with other medicating scheme. The more diffieuhy made choice of having or not having child, the more irregular med- icating. The more understood knowledge for prevention mother - infant transmission, the more regular medicating. The higher hostility was, the more irregular medicating. The more worry about child care in future, the more irregular medicating. Conclusion： Influencing factors of the HIV -positive pregnant women are more complex, compared with common HIV infected people. The suggestion is combining prenatal care and the specific circumstances of tile patients , to establish the individualized service and the follow - up methods. On the other hand, it is to strengthen the doctor - patient communication, to establish a relationship of trust and to optimize medicating scheme.

关 键 词：预防 艾滋病 母婴传播 规律用药 影响因素 

分 类 号：R593.32[医药卫生—内科学]