HIV感染者/AIDS患者高效抗逆转录病毒治疗感知效果影响因素分析  

Influencing factors of highly active antiretroviral therapy perceived effect in people living with HIV or AIDS

作　　者：郑艳[1] 王志勇[1] 陈橙 吴伶俐 夏云丽 Zheng Yan;Wang Zhiyong;Chen Cheng;Wu Lingli;Xia Yunli(Jiulongpo District Center for Disease Control and Prevention)

机构地区：[1]重庆市九龙坡区疾病预防控制中心,重庆400039

出　　处：《重庆医科大学学报》2021年第4期493-498,共6页Journal of Chongqing Medical University

基　　金：重庆市九龙坡区科技局资助项目(编号:[2017]55号)。

摘　　要：目的:研究影响HIV感染者/AIDS患者(people living with HIV or AIDS,PLWH)感知高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)效果的影响因素,为促进抗病毒治疗提供科学依据。方法:采用回顾性调查研究方法和面对面问卷调查收集一般人口学信息、艾滋病基本知识、服药情况、服药依从性、HAART疗效自我感知等信息。采用卡方检验、秩和检验、有序分类变量logistic回归进行统计学分析。结果:共收集到321名调查对象的有效信息,艾滋病基本知识知晓率为88.16%,最近1年有259例患者开展了HIV病毒载量检测,258例病毒载量<50拷贝/mL,最近1次CD4+T细胞平均为(444.23±178.29)个/μL。70.09%的PLWH感知到治疗效果为"有效",6.23%的PLWH感知到治疗效果"非常有效"。出现不良反应后可否自行停药或者减药(OR=0.337,95%CI=0.178~0.638)、治疗前CD4+T细胞数量(OR=2.931,95%CI=1.479~5.807)和治疗持续时间(OR=0.438,95%CI=0.230~0.835)这3个变量对感知疗效有影响。结论:HAART治疗效果较好,但与感知效果存在不一致性,家人支持、服药依从性、艾滋病防治知识、治疗前CD4+T细胞水平、治疗时间对自我感知疗效有影响,建议采取心理干预、依从性教育等综合干预措施,促进PLWH自我感知效果提高。Objective:To investigate influencing factors of the perceived effect of highly active antiretroviral therapy(HAART)in people living with HIV or AIDS(PLWH),and to provide scientific basis for the promotion of antiviral therapy.Methods:Retrospective survey was conducted in this study,and face-to-face questionnaire survey was used to collect general demographic information,basic knowledge of AIDS,medication status,medication adherence,and perceived effect of HAART.Chi-square test,rank sum test and ordered categorical variable logistic regression were used as statistical methods.Results:We collected complete information of 321 subjects,and the awareness rate of basic knowledge of AIDS was 88.16%.In the last year,259 patients had been tested for HIV viral load,258 of which had a viral load of<50 copies/mL,and the average CD4+T cell was(444.23±178.29)/μL for the last time.70.09%of PLWH perceived the therapeutic effect as"effective",and 6.23%of PLWH perceived the therapeutic effect as"very effective".Awareness of stopping or reducing drug taking while adverse reactions occurred(OR=0.337,95%CI=0.178-0.638),the number of CD4+T cells before treatment(OR=2.931,95%CI=1.479-5.807),duration of treatment(OR=0.438,95%CI=0.230-0.835)had influence on perceived efficacy.Conclusion:HAART has a good therapeutic effect,but it’s inconsistent with the perceived effect.Family support,medication compliance,knowledge of AIDS prevention,CD4+T cell level before treatment,and treatment time were associated with self-perceived efficacy.It’s suggested to take comprehensive intervention measures such as psychological intervention and compliance education to improve the self-perceived effect of PLWH.

关 键 词：艾滋病 高效抗逆转录病毒治疗 感知效果 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]