Determinants of poor adherence to antiretroviral treatment using a combined effect of age and education among human immunodeficiency virus infected young adults attending care at Letaba Hospital HIV Clinic, Limpopo Province, South Africa
Determinants of poor adherence to antiretroviral treatment using a combined effect of age and education among human immunodeficiency virus infected young adults attending care at Letaba Hospital HIV Clinic, Limpopo Province, South Africa
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DOI：
10.11604/pamj.2019.32.37.17722
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发表时间：
2019-01-18
影响因子：
1.2
通讯作者：
Nyasulu, Peter
中科院分区：
文献类型：
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作者：
Mabunda, Kuhlula;Ngamasana, Emery Ladi;Nyasulu, Peter
简介：使用抗逆转录病毒治疗 (ART) 进行持续病毒抑制的情况下，治疗依从率至少为 95%。不依从性会促进感染人类免疫缺陷病毒的个体产生耐药性和治疗失败。在林波波省，依从率约为 61%，但莱塔巴医院艾滋病毒诊所的患病率和与依从性相关的因素尚未明确。因此，本研究的目的是确定与就诊的 18-35 岁 HIV 感染年轻人依从性相关的因素。方法：在Letaba HIV诊所对18-35岁的年轻人进行横断面调查。进行逻辑回归分析以确定与 ART 依从性相关的因素。我们报告了优势比以及相应的 95% 置信区间和 p 值。 p 值 < 0.1 被认为具有统计显着性。 ART 依从性定义为在完成问卷前 3 天接受超过 95% 的处方治疗。结果：共有 281 名参与者参加，其中 163 名（58.0%）女性，四分之三以上，222 名（79.0%）年龄在 18 岁至 29 岁之间。 245 名参与者的 ART 总体依从率为 (87.2%)（95% CI：63.0%-89.0%）。不坚持治疗的人，36 名（12.8%）：患者报告没有理由（3.9%）、忘记（3.2%）、感觉良好（3.2%）、恐惧和停止治疗（2.5%）作为在数据收集前三天内不接受治疗的一些原因。以下因素：高等教育（p = 0.07）、年龄（30-35；p 值：0.07）、药物可用性（p 值：0.07）与 ART 依从性仅略有显着相关。结论：研究发现我们的参与者对 ART 的依从性不满意。我们的研究表明，社会人口统计学和临床因素以外的因素可能更好地解释依从性的差异。这凸显了需要进行更复杂的研究，研究这些患者所处的整个系统以及他们的心理模型。
Introduction: sustained viral suppression using antiretroviral treatment (ART) occurs with adherence to treatment of at least 95%. Non-adherence promotes the development of drug-resistance and treatment failure in individuals infected with Human Immunodeficiency Virus. In Limpopo Province, the adherence rate is approximately 61%, but the prevalence and the factors associated with adherence at Letaba hospital HIV clinic are not well established. Therefore, the aim of this study was to identify the factors associated with adherence among HIV-infected young adults, aged 18-35 years, attending the clinic. Methods: a cross-sectional survey was conducted in Letaba HIV clinic among young adults of 18-35 years old. Logistic regression analysis was performed to determine factors associated with ART adherence. We reported odds ratios with the corresponding 95% confidence intervals and p-values. A p-value < 0.1 was considered as statistically significant. ART adherence was defined as taking more than 95% of the prescribed treatment, 3 days prior to completion of the questionnaire. Results: a total of 281 participants were enrolled with 163 (58.0%) females and more than three quarter, 222 (79.0%) between the ages of 18 and 29 years. The overall ART adherence stood at (87.2%) (95% CI: 63.0%-89.0%) representing 245 participants. Non-adherers to treatment, 36 (12.8%): patients reported no reason (3.9%), forgetting (3.2%), feeling good (3.2%), fear and running out of treatment (2.5%) as some of the reasons for not taking treatment within the three days prior to data collection. The following factors: tertiary education (p = 0.07), age (30-35; p-value: 0.07), drug availability (p-value: 0.07), were only marginally significantly associated with ART adherence. Conclusion: the study found unsatisfactory ART adherence among our participants. Our study suggests that factors other than sociodemographic and clinical factors might better explain differences in adherence. This highlights the need for a more complex study that would look at the entire system in which these patients are navigating as well as their mental models.