High levels of adherence and viral suppression in a nationally representative sample of HIV-infected adults on antiretroviral therapy for 6, 12 and 18 months in Rwanda.
High levels of adherence and viral suppression in a nationally representative sample of HIV-infected adults on antiretroviral therapy for 6, 12 and 18 months in Rwanda.
复制标题
DOI：
10.1371/journal.pone.0053586
复制
发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Asiimwe A
中科院分区：
文献类型：
--
作者：
Elul B;Basinga P;Nuwagaba-Biribonwoha H;Saito S;Horowitz D;Nash D;Mugabo J;Mugisha V;Rugigana E;Nkunda R;Asiimwe A
需要有关于非洲接受抗逆转录病毒疗法的患者坚持治疗和病毒学抑制的程度和决定因素的可推广的数据。我们进行了一项横断面调查，图表摘要，患者访谈和网站评估在全国代表性样本的成人ART 6，12和18个月在卢旺达的20个网站。使用3天和30天患者回忆评估依从性。系统选择的子样本进行病毒载量（VL）测量。多变量逻辑回归分析了非完美（<100%）30天依从性和可检测VL（>40拷贝/ml）的预测因素。总体而言，1，417名成年人接受了采访，837人进行了VL测量。分别有94%和78%的人报告在过去3天和30天内完全遵守。83%的人检测不到VL。在调整后的模型中，与非完美30天依从性的几率较高独立相关的特征是：接受ART治疗18个月（vs. 6个月）;年龄较小;报告重度在前30天内（与无或很少）副作用;在ART开始时没有记录CD 4细胞计数（与CD 4细胞计数<200个细胞/微升相比）;饮酒;以及在2003-2004年和2005年开始ART服务的就诊地点（与2006-2007年相比）;接受抗逆转录病毒治疗的患者人数≥600人（与<600人）的站点;或有同伴教育者的站点。参加艾滋病毒/艾滋病感染者协会;在定期进行家访的地点接受护理与不遵守规定的可能性较低独立相关。在有同伴教育者的站点中，观察到患者具有可检测的VL的几率更高。女性;参与与PLWHA相关的研究;使用提醒工具与可检测VL的几率较低独立相关。在卢旺达国家ART项目中观察到高水平的依从性和病毒抑制，并与潜在的可改变因素相关。
Generalizable data are needed on the magnitude and determinants of adherence and virological suppression among patients on antiretroviral therapy (ART) in Africa. We conducted a cross-sectional survey with chart abstraction, patient interviews and site assessments in a nationally representative sample of adults on ART for 6, 12 and 18 months at 20 sites in Rwanda. Adherence was assessed using 3- and 30-day patient recall. A systematically selected sub-sample had viral load (VL) measurements. Multivariable logistic regression examined predictors of non-perfect (<100%) 30-day adherence and detectable VL (>40 copies/ml). Overall, 1,417 adults were interviewed and 837 had VL measures. Ninety-four percent and 78% reported perfect adherence for the last 3 and 30 days, respectively. Eighty-three percent had undetectable VL. In adjusted models, characteristics independently associated with higher odds of non-perfect 30-day adherence were: being on ART for 18 months (vs. 6 months); younger age; reporting severe (vs. no or few) side effects in the prior 30 days; having no documentation of CD4 cell count at ART initiation (vs. having a CD4 cell count of <200 cells/µL); alcohol use; and attending sites which initiated ART services in 2003–2004 and 2005 (vs. 2006–2007); sites with ≥600 (vs. <600 patients) on ART; or sites with peer educators. Participation in an association for people living with HIV/AIDS; and receiving care at sites which regularly conduct home-visits were independently associated with lower odds of non-adherence. Higher odds of having a detectable VL were observed among patients at sites with peer educators. Being female; participating in an association for PLWHA; and using a reminder tool were independently associated with lower odds of having detectable VL. High levels of adherence and viral suppression were observed in the Rwandan national ART program, and associated with potentially modifiable factors.
登录
查看更多内容
DOI：
10.1177/1545109708328130
发表时间：
2008-11
期刊：
Journal of the International Association of Physicians in AIDS Care (Chicago, Ill. : 2002)
影响因子：
--
作者：
Kalichman SC;Pope H;White D;Cherry C;Amaral CM;Swetzes C;Flanagan J;Kalichman MO
通讯作者：
Kalichman MO
影响因子：
6.4
作者：
Graham, Susan M.;Masese, Linnet;McClelland, R. Scott
通讯作者：
McClelland, R. Scott
影响因子：
3.4
作者：
Kip, Esther;Ehlers, Valerie J.;van der Wal, Dirk M.
通讯作者：
van der Wal, Dirk M.
DOI：
10.1080/09540120903193625
发表时间：
2010-01-01
影响因子：
1.7
作者：
Kipp, Walter;Alibhai, Arif;Rubaale, Tom
通讯作者：
Rubaale, Tom
DOI：
10.1080/09540120050042891
发表时间：
2000-06-01
影响因子：
1.7
作者：
Chesney, MA;Ickovics, JR;Wu, AW
通讯作者：
Wu, AW