社区组织服务对艾滋病抗病毒治疗者服药依从性的影响  

Impact of community-based organization services on adherence to medication among HIV/AIDS patients

作　　者：范笑嫣 刘聪[2] 钟海丹[2] 何强生 杨廷龙 陈唯一 李凌华[2] 顾菁[1] FAN Xiao⁃yan;LIU Cong;ZHONG Hai⁃dan;HE Qiang⁃sheng;YANG Ting⁃long;CHEN Wei⁃yi;LI Ling⁃hua;GU Jing(School of Public Health,Sun Yat⁃sen University,Guangzhou,Guangdong 510080;Department of Infections Disease,Guangzhou Eighth People's Hospital,Guangzhou,Guangdong 510080,China)

机构地区：[1]中山大学公共卫生学院医学统计系,广东广州510080 [2]广州市第八人民医院感染科门诊,广东广州510080

出　　处：《热带医学杂志》2020年第3期336-340,共5页Journal of Tropical Medicine

基　　金：国家自然科学基金(717741784);国家科技重大专项(2018ZX10715004);广东省科学(技术)研究专项(2017A020212006);广州市科学(技术)研究专项(201607010368)。

摘　　要：目的探索是否接受社区组织(CBO)服务对广州市新开始抗逆转录病毒治疗(ART)的艾滋病病毒(HIV)感染者长期抗病毒治疗依从性的影响。方法采用前瞻性队列研究设计,从2016年6月到2017年5月在广州市第八人民医院招募新开始治疗的HIV感染者作为研究对象。基线时调查研究对象的人口学特征,HIV相关变量,对ART相关政策和知识的了解程度以及是否接受CBO的服务。12个月后调查研究对象的ART依从性。采用Logistic回归分析CBO的服务对于患者治疗依从性的影响。结果共有433例调查对象完成基线调查问卷,有52.5%接受过广同/岭南等CBO的服务。338例完成12个月随访。整体的ART依从率为85.1%,其中CBO服务组的依从率为89.0%,无CBO服务组依从率为80.7%。校正背景变量后,接受CBO的服务的研究对象依从比例显著高于未接受CBO服务的患者(OR=2.14,95%CI:1.11~4.14,P=0.024)。结论广州市新开始ART的患者长期依从性较好,通过进一步扩大CBO的服务范围,提升CBO的服务能力,能够进一步改善HIV感染者的ART依从性。Objective The study aimed to explore the influence of community-based organization(CBO)services on the long-term adherence to antiretroviral therapy(ART)among HIV-infected individuals in Guangzhou.Methods A prospective cohort study was adopted.HIV-infected individuals newly initiating ART were recruited from June 2016 to May s Hospital.In the baseline survey,the demographic characteristics,HIV-related variables,awareness of ART policy and knowledge about ART were measured.The participants were also asked whether they received CBO services.During the follow-up at month 12,participants were asked about their medication adherence.Logistic regression model was adopted to analyze the association between receiving services from CBO and ART adherence with adjustment for potential confounding factors.Results Of all the 433 participants that finished baseline survey,52.5%had received services from CBO.In month-12,338 completed follow-up questionnaires.Overall,85.1%reported adequate adherence,with 89.0%and 80.7%in the CBO group and non-CBO group,respectively.After adjusting the background variables,the subjects receiving service from CBO were significantly more likely to report adequate adherence compared to those who did not receive the CBO service(OR=2.14,95%CI:1.11-4.14,P=0.024).Conclusion The long-term ART adherence of patients newly initiating ART in Guangzhou was acceptable.Expanding the service scope of CBOs and improving CBO service capacity can further improve the ART adherence of HIV-infected populations.

关 键 词：艾滋病 抗病毒治疗 依从性 社区组织 

分 类 号：R512.91[医药卫生—内科学]