摘要
目的通过对深圳市福田区HIV/AIDS患者抗病毒治疗依从性差异的情况进行调查研究,分析其影响因素,为探索创建针对性的提高HIV/AIDS患者抗病毒治疗依从性的综合干预模式提供一定的科学依据。方法选取2012年4月-2013年12月"中国疾病预防控制信息系统"中现住址在福田区,存活且可随访到的符合免费抗病毒治疗标准的HIV感染者/AIDS患者(排除港澳台病例及羁押人员)230人,根据设计好的《福田区HIV/AIDS患者抗病毒治疗依从性调查问卷》进行调查,收集问卷后按照服药依从性评估问卷分为高依从性(n=108人)和低依从性(n=122人)两组进行对照比较,对两组的流行病学、临床、社会-心理-行为特征等资料进行统计学分析,了解影响其抗病毒治疗依从性的相关影响因素。结果依从性不同两组在"对社会支持是否满意"变量上差异有统计学意义(χ2=7.87,P<0.05),显示对社会支持的满意程度不同对依从性高低有着显著性影响,对社会支持满意度高的患者抗病毒治疗依从性也更趋向于高。将单因素分析中有意义的变量和一般人口学特征变量拟合二分类Logistic回归模型,结果显示临床分期(OR=1.682,P<0.05)合并CD4淋巴细胞计数(OR=1.351,P<0.05)是依从性高低的重要影响因素,临床分期晚、CD4细胞计数低的患者依从性较高,差异有统计学意义。结论应加大宣传教育,取得更好的对艾滋病患者的社会支持度,并促进患者对加强抗病毒治疗知识掌握,对治疗人群采用必要的综合措施促使其能依从服药,更重要的是要尽量使HIV感染者在病程早期治疗,可以保证较高的治疗依从性。
Objective To investigate and study the difference in compliance of HIV antiretroviral treatment among HIV / AIDS patients in Futian District,Shenzhen City,to analyze its influencing factors so as to provide scientific evidence for developing a targeted comprehensive intervention model concerning improving the compliance of antiretroviral treatment of HIV / AIDS patients.Methods A total of 230 living patients with HIV / AIDS,who could be followed up,lived in Futian District and met the free antiretroviral treatment standard( excluding the patients from Hong Kong,Macao,Taiwan and prisons) were selected from China Information System for Disease Control and Prevention from April 2012 to December 2013,and then Questionnaire Concerning the Compliance of HIV Antiretroviral Treatment among HIV / AIDS Patients in Futian District was used to conduct the survey. After evaluating the results of the survey,the patients were divided into the good compliance group( n = 108) and the poor compliance group( n = 122). The data about epidemiological,clinical and society- psychology- behavior characteristics of the two groups were statistically analyzed,and the related factors influencing the compliance of antiretroviral treatment were investigated. Results There were statistically significant differences in the variable concerning"whether or not the patients were satisfied with the social support"between the two groups( χ2= 7. 87,P < 0. 05),suggesting that the degree of the satisfaction with the social support had a significant impact on the compliance level. The higher the satisfaction with the social support,the better the compliance of the antiretroviral treatment. The variables of statistical significance in single factor analysis and general demographic variables were employed to fit the binary Logistic regression model,and the results showed that the clinical stage( OR = 1. 682,P < 0. 05)combined with CD4 lymphocyte count( OR = 1. 351,P < 0. 05) was the important factor influencing the compliance level. AIDS patients at later clinical- stage or with lower CD4 lymphocyte count had good compliance,with statistically significant differences.Conclusions It is necessary to intensify the publicity and education,promote the social support for HIV / AIDS patients,improve the patients' knowledge about HIV antiretroviral treatment and adopt necessary comprehensive measures to promote the adherence to medicine taking in HIV / AIDS patients with antiretiovial treatment. It is imperative that HIV- infected patients should be treated as early as possible so as to ensure their good therapy compliance.
引文
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