西安市HIV/AIDS病人HAART依从性相关研究  

Antiretroviral therapy adherence among HIV/AIDS patients in Xi'an

作　　者：姚娜[1] 汪春付[1] 赵生魁 金小雅 于卓然[1] 赵柯[1] 刘青[1] 孙永涛[1] 

机构地区：[1]第四军医大学唐都医院传染科,西安710038 [2]西安市第八医院,西安710061

出　　处：《中国艾滋病性病》2015年第3期184-188,共5页Chinese Journal of Aids & STD

基　　金：国家"十二五"科技重大专项(2014ZX10001002)~~

摘　　要：目的对西安市目前启动高效抗反转录病毒治疗(HAART)的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)的服药依从性现状进行调查研究,分析影响依从性的因素及其与治疗结局的关系。方法采用横断面调查方法。收集病人的一般人口学特征、依从性相关信息知晓情况、服药行为、CD+4T淋巴细胞计数、病毒载量等信息进行统计学分析。结果共调查535例服药病例,474例(88.6%)报告最近一个月无漏服或超过固定时间2小时服药。多因素Logistic回归分析提示,影响服药依从性的主要因素有:宗教信仰[比值比(OR)=15.837,P=0.011]、每天服药次数(OR=3.905,P<0.001)、饮酒(OR=3.058,P=0.007)、服药提醒装置(OR=3.012,P=0.001)、按时随访(OR=2.079,P=0.025)、依从性相关信息知晓状况(OR=1.558,P<0.001)。治疗过程中发生病毒学失败31例。多元回归分析结果提示,治疗时间和依从性是影响病毒学应答的关键因素。结论 HIV/AIDS病人的服药依从性直接影响治疗结局,它的建立是一个多因素综合作用的过程,与信息-动机-行为(IMB)技能模型契合,在今后的临床工作中可通过强化病人对ART相关信息的认知、服药动机及服药行为技能提高依从性。Objective To examine the current status and influencing factors of antiretroviral therapy（ART）adherence among people living with HIV/AIDS,and to explore its relationship with treatment outcomes.Methods A cross-sectional survey was conducted with ART-provided patients using face to face questionnaire.Statistical analyses include the general demographic characteristics,adherence-related information,medication behavioral,CD＋4T cell count and HIV viral load.Results A total of 535ART-provided patients were investigated,with 474（88.6%）reported no missed doses or mistiming their medication for more than 2hours in the four-weeks prior to interview.Multivariate logistic regression analysis showed that major influencing factors were religious belief（OR=15.837,P=0.011）,frequency of daily doses（OR=3.905,P〈0.001）,alcohol use（OR=3.058,P=0.007）,use of reminder tools（OR=3.012,P=0.001）,schedule follow-ups（OR=2.079,P=0.025）,the knowledge of adherencerelated information（OR=1.558,P〈0.001）.Thirty one patients occurred virologic failure during the treatment,length of the treatment and adherence were associated with HIV virologic response in multivariate analysis.Conclusion The develop of optimal adherence directly affects treatment outcomes,it includes comprehensive factors which were well characterized by the Information-Motivation-Behavioral Skills model.In further clinical work,health care providers could strengthen ART-related information,motivation and behavioral skills to promote ART adherence.

关 键 词：艾滋病病人 抗病毒治疗 依从性 

分 类 号：R512.91[医药卫生—内科学]