HIV阳性男男性行为者抗病毒治疗依从性现状及影响因素研究
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摘要
目的调查长沙市接受抗病毒治疗(ART)的艾滋病病毒(HIV)阳性男男性行为者(MSM)服药依从性现状及相关因素,为提高该群体的ART服药依从性提供信息支持。方法于2017年4—10月期间,在长沙市某传染病医院艾滋病门诊对接受ART时间大于1个月的300例HIV阳性MSM进行匿名面访调查。采用二分类Logistic回归分析病人的社会人口学资料与疾病情况对其服药依从性的影响。结果回收有效问卷274份,应答率为91.3%。85.8%(235份)的HIV阳性MSM的ART服药依从性良好。有提醒服药方法[比值比(OR)=5.948,95%可信区间(CI):2.273～15.565)],不/偶尔饮酒(OR=4.415,95%CI:2.001～9.740),告知他人感染情况(OR=3.458,95%CI:1.570～7.618),文化程度高(OR=2.860,95%CI:1.336～6.121)是HIV阳性MSM的抗病毒治疗服药依从性的保护因素。结论长沙市HIV阳性MSM的ART服药依从性整体水平较好,但受多种因素影响。
Objective To explore antiretroviral treatment(ART)adherence and related factors among HIV-positive men who have sex with men(MSM)in Changsha,and to provide a scientific basis for improving ART adherence.Methods A cross-sectional study was conducted from April to October 2017 among HIV-positive MSM on ART for at least one month in an infectious disease hospital in Changsha.Binary logistic regression analysis was used to analyze the predictors of the ART adherence.Results 300 subjects were recruited and 274 valid questionnaires(91.3%)were collected.85.8%(235/274)of HIV-positive MSM had good adherence to ART.Reminders to take medicine(OR=5.948,95%CI2.273-15.565),no/seldom alcohol use(OR=4.415,95%CI 2.001-9.740),HIV disclosure(OR=3.458,95%CI 1.570-7.618)and high education level(OR=2.860,95%CI 1.336-6.121)were positive factors of ART adherence.Conclusion The overall level of ART compliance of HIV-positive MSM is good and it is affected by many factors.
Objective To explore antiretroviral treatment(ART)adherence and related factors among HIV-positive men who have sex with men(MSM)in Changsha,and to provide a scientific basis for improving ART adherence.Methods A cross-sectional study was conducted from April to October 2017 among HIV-positive MSM on ART for at least one month in an infectious disease hospital in Changsha.Binary logistic regression analysis was used to analyze the predictors of the ART adherence.Results 300 subjects were recruited and 274 valid questionnaires(91.3%)were collected.85.8%(235/274)of HIV-positive MSM had good adherence to ART.Reminders to take medicine(OR=5.948,95%CI2.273-15.565),no/seldom alcohol use(OR=4.415,95%CI 2.001-9.740),HIV disclosure(OR=3.458,95%CI 1.570-7.618)and high education level(OR=2.860,95%CI 1.336-6.121)were positive factors of ART adherence.Conclusion The overall level of ART compliance of HIV-positive MSM is good and it is affected by many factors.
引文
[1]中国疾病预防控制中心性病艾滋病预防控制中心性病控制中心.2018年4月全国艾滋病性病疫情[J].中国艾滋病性病,2018,24(6):535.
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[3]Mannheimer SB,Mukherjee R,Hirschhorn LR,et al.The CASE adherence index:A novel method for measuring adherence to antiretroviral therapy[J].AIDS Care,2006,18(7):853-861.
[4]李萌.南京市HIV感染者/AIDS病人抗病毒治疗依从性及终止治疗影响因素研究[D].北京:中国疾病预防控制中心,2015.
[5]Huang L,Li L,Zhang Y,et al.Self-efficacy,medication adherence,and quality of life among people living with HIV in Hunan Province of China:aquestionnaire survey[J].Journal of the Association of Nurses in Aids Care Janac,2013,24(2):145-153.
[6]Zhou H,Wang F,Liu L,et al.Comparisons of adherence to antiretroviral therapy in a high-risk population in China:A systematic review and meta-analysis[J].PLoS One,2016,11(1):e146659.
[7]周月芳,高美霞,孙盈红,等.MSM人群中艾滋病病人服药依从性的心理状况分析及其护理[J].中国艾滋病性病,2012,18(11):746-748.
[8]陈卫建,吴文君,傅涛,等.义乌市志愿者小组管理男男性行为者中HIV感染者5年效果分析[J].中国艾滋病性病,2016,22(6):448-450.
[9]中华人民共和国工业和信息化部运行监测协调局.2016年通信运营业统计公报[EB/OL].[0408].http://www.miit.gov.cn/n1146290/n1146402/n1146455/c5471508/content.html.
[10]Tsega B,Srikanth BA,Shewamene Z.Determinants of non-adherence to antiretroviral therapy in adult hospitalized patients,Northwest Ethiopia[J].Patient Preference&Adherence,2015(9):373-380.
[11]Horvath KJ,Alemu D,Danh T,et al.Creating effective mobile phone Apps to optimize antiretroviral therapy adherence:perspectives from stimulant-using HIV-positive men who have sex with men[J].JMIR Mhealth Uhealth,2016,4(2):e48.
[12]Grange RL,Lewis M,Rockwern B.Using mobile technology to support adherence to medication:SMS text reminders and young people living with HIV[J].Journal of Adolescent Health,2012,50(2):S94.
[13]Hendershot CS,Stoner SA,Pantalone DW,et al.Alcohol use and antiretroviral adherence:review and meta-analysis[J].J Acquir Immune Defic Syndr,2009,52(2):180-202.
[14]Pokhrel KN,Pokhrel KG,Neupane SR,et al.Harmful alcohol drinking among HIV-positive people in Nepal:an overlooked threat to anti-retroviral therapy adherence and health-related quality of life[J].Glob Health Action,2018,11(1):1441783.
[15]Cook RL,Sereika SM,Hunt SC,et al.Problem drinking and medication adherence among persons with HIV infection[J].JGen Intern Med,2001,16(2):83-88.
[16]Daskalopoulou M,Lampe FC,Sherr L,et al.Non-disclosure of HIV status and associations with psychological factors,ARTnon-adherence,and viral load non-suppression among people living with HIV in the UK[J].Aids&Behavior,2017,21(1):184-195.
[17]Micheni M,Secor A,Elst EVD,et al.Facilitators and challenges to ART adherence among men who have sex with men(MSM)in Coastal Kenya[J].Aids Research&Human Retroviruses,2014(30):A136.
[18]Maqutu D,Zewotir T,North D,et al.Determinants of optimal adherence over time to antiretroviral therapy amongst HIV positive adults in South Africa:A longitudinal study[J].Aids&Behavior,2011,15(7):1465-1474.
[2]Qi J,Zhang D,Fu X,et al.High risks of HIV transmission for men who have sex with men-A comparison of risk factors of HIVinfection among MSM associated with recruitment channels in 15cities of China[J].PLoS One,2015,10(4):e121267.
[3]Mannheimer SB,Mukherjee R,Hirschhorn LR,et al.The CASE adherence index:A novel method for measuring adherence to antiretroviral therapy[J].AIDS Care,2006,18(7):853-861.
[4]李萌.南京市HIV感染者/AIDS病人抗病毒治疗依从性及终止治疗影响因素研究[D].北京:中国疾病预防控制中心,2015.
[5]Huang L,Li L,Zhang Y,et al.Self-efficacy,medication adherence,and quality of life among people living with HIV in Hunan Province of China:aquestionnaire survey[J].Journal of the Association of Nurses in Aids Care Janac,2013,24(2):145-153.
[6]Zhou H,Wang F,Liu L,et al.Comparisons of adherence to antiretroviral therapy in a high-risk population in China:A systematic review and meta-analysis[J].PLoS One,2016,11(1):e146659.
[7]周月芳,高美霞,孙盈红,等.MSM人群中艾滋病病人服药依从性的心理状况分析及其护理[J].中国艾滋病性病,2012,18(11):746-748.
[8]陈卫建,吴文君,傅涛,等.义乌市志愿者小组管理男男性行为者中HIV感染者5年效果分析[J].中国艾滋病性病,2016,22(6):448-450.
[9]中华人民共和国工业和信息化部运行监测协调局.2016年通信运营业统计公报[EB/OL].[0408].http://www.miit.gov.cn/n1146290/n1146402/n1146455/c5471508/content.html.
[10]Tsega B,Srikanth BA,Shewamene Z.Determinants of non-adherence to antiretroviral therapy in adult hospitalized patients,Northwest Ethiopia[J].Patient Preference&Adherence,2015(9):373-380.
[11]Horvath KJ,Alemu D,Danh T,et al.Creating effective mobile phone Apps to optimize antiretroviral therapy adherence:perspectives from stimulant-using HIV-positive men who have sex with men[J].JMIR Mhealth Uhealth,2016,4(2):e48.
[12]Grange RL,Lewis M,Rockwern B.Using mobile technology to support adherence to medication:SMS text reminders and young people living with HIV[J].Journal of Adolescent Health,2012,50(2):S94.
[13]Hendershot CS,Stoner SA,Pantalone DW,et al.Alcohol use and antiretroviral adherence:review and meta-analysis[J].J Acquir Immune Defic Syndr,2009,52(2):180-202.
[14]Pokhrel KN,Pokhrel KG,Neupane SR,et al.Harmful alcohol drinking among HIV-positive people in Nepal:an overlooked threat to anti-retroviral therapy adherence and health-related quality of life[J].Glob Health Action,2018,11(1):1441783.
[15]Cook RL,Sereika SM,Hunt SC,et al.Problem drinking and medication adherence among persons with HIV infection[J].JGen Intern Med,2001,16(2):83-88.
[16]Daskalopoulou M,Lampe FC,Sherr L,et al.Non-disclosure of HIV status and associations with psychological factors,ARTnon-adherence,and viral load non-suppression among people living with HIV in the UK[J].Aids&Behavior,2017,21(1):184-195.
[17]Micheni M,Secor A,Elst EVD,et al.Facilitators and challenges to ART adherence among men who have sex with men(MSM)in Coastal Kenya[J].Aids Research&Human Retroviruses,2014(30):A136.
[18]Maqutu D,Zewotir T,North D,et al.Determinants of optimal adherence over time to antiretroviral therapy amongst HIV positive adults in South Africa:A longitudinal study[J].Aids&Behavior,2011,15(7):1465-1474.