Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru.
Alcohol use disorders negatively influence antiretroviral medication adherence among men who have sex with men in Peru.
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DOI：
10.1080/09540121.2014.963013
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发表时间：
2015
期刊：
影响因子：
1.7
通讯作者：
Altice FL
中科院分区：
文献类型：
--
作者：
Ferro EG;Weikum D;Vagenas P;Copenhaver MM;Gonzales P;Peinado J;Cabello R;Lama JR;Sanchez J;Altice FL
随着国际指南在全球范围内增加抗逆转录病毒疗法（ART）的可及性，坚持ART对于实现艾滋病毒治疗即预防（TasP）目标变得越来越重要。在秘鲁利马的男男性行为者（MSM）和变性妇女（TGW）中集中流行艾滋病毒的情况下，对不坚持抗逆转录病毒疗法的独立相关因素进行了研究，以告知治疗干预的优先事项。秘鲁利马从事临床护理的HIV感染MSM和TGW的横断面调查。从2012年6月至8月，302名艾滋病毒感染的秘鲁MSM/TGW从三个临床护理站点招募方便抽样参加横断面计算机辅助依从性调查。检查了与ART非依从性相关的几种标准化筛选指标，以确定最佳（≥90%）和完美（100%）依从性的独立相关性，并使用logistic回归进行评估。在招募的302名参与者中，263名（87.1%）接受了ART治疗。在这些接受ART治疗的患者中，229名（87.1%）报告最佳依从性，146名（55.5%）报告完全依从性。酒精使用障碍（AUD; 43.2%）、酒精依赖（5.3%）、近期药物使用（6.0%）和抑郁（44.5%）的患病率较高，大多数参与者有神经认知障碍的证据。符合AUD标准和抑郁症是共线的（p<0.001）。在多变量分析中，AUD与最佳（AOR=0.427; 95% CI=0.187-0.976）和完美（AOR=0.552; 95% CI=0.327-0.930）ART依从性呈负相关，并且是唯一的独立相关性。AUDs在秘鲁艾滋病毒感染的男男性行为者中非常普遍，并对ART不依从性有显著影响。这些发现支持了筛查和治疗潜在AUD的必要性。为了实现艾滋病毒TasP目标，针对AUDs的循证策略可能会直接改善ART依从性，间接改善整体个人健康，艾滋病毒治疗参与度，并减少这一脆弱和受影响人群中的性伴侣传播。
As international guidelines increase access to antiretroviral therapy (ART) globally, ART adherence becomes increasingly important to achieve HIV treatment as prevention (TasP) goals. In the concentrated HIV epidemic among men who have sex with men (MSM) and transgendered women (TGW) in Lima, Peru, the independent correlates of ART non-adherence were examined to inform treatment intervention priorities. Cross sectional survey of HIV-infected MSM and TGW who are engaged in clinical care in Lima, Peru. From June to August 2012, 302 HIV-infected Peruvian MSM/TGW from three clinical care sites were recruited using convenience sampling to participate in a cross-sectional computer-assisted adherence survey. Several standardized screening measures associated with ART non-adherence were examined in order to determine the independent correlates of optimal (≥90%) and perfect (100%) adherence, which were assessed using logistic regression. Of the 302 participants recruited, 263 (87.1%) were prescribed ART. Among those prescribed ART, 229 (87.1%) reported optimal and 146 (55.5%) reported perfect adherence. The prevalence of alcohol use disorders (AUD; 43.2%), alcohol dependence (5.3%), recent drug use (6.0%) and depression (44.5%) was high and most participants had some evidence of neurocognitive impairment. Meeting criteria for having an AUD and depression were collinear (p<0.001). On multivariate analysis, having an AUD was inversely related and the only independent correlate of optimal (AOR=0.427; 95% CI=0.187–0.976) and perfect (AOR=0.552; 95% CI=0.327–0.930) ART adherence. AUDs are highly prevalent among Peruvian HIV-infected MSM and contribute significantly to ART non-adherence. These findings support the need for screening and treating underlying AUDs. In order to meet HIV TasP goals, evidence-based strategies targeting AUDs are likely to directly improve ART adherence and indirectly improve overall individual health, HIV treatment engagement and reduce transmission to sexual partners among this vulnerable and disproportionally affected population.
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影响因子：
4.4
作者：
Jacob, Shevin T.;Baeten, Jared M.;Hughes, James P.;Peinado, Jesus;Wang, Jing;Sanchez, Jorge;Reid, Stewart E.;Delany-Moretlwe, Sinead;Cowan, Frances;Fuchs, Jonathan D.;Koblin, Beryl;Griffith, Sam;Wald, Anna;Celum, Connie
通讯作者：
Celum, Connie
影响因子：
4.9
作者：
Brigido, LFM;Rodrigues, R;Duarte, AJS
通讯作者：
Duarte, AJS
影响因子：
168.9
作者：
Beyrer, Chris;Baral, Stefan D.;van Griensven, Frits;Goodreau, Steven M.;Chariyalertsak, Suwat;Wirtz, Andrea L.;Brookmeyer, Ron
通讯作者：
Brookmeyer, Ron
影响因子：
4.2
作者：
Azar, Marwan M.;Springer, Sandra A.;Meyer, Jaimie P.;Altice, Frederick L.
通讯作者：
Altice, Frederick L.
影响因子：
1.7
作者：
Chander G;Himelhoch S;Fleishman JA;Hellinger J;Gaist P;Moore RD;Gebo KA
通讯作者：
Gebo KA