Predictors of Treatment Adherence and Virological Failure Among People Living with HIV Receiving Antiretroviral Therapy in a South African Rural Community: A Sub-study of the ITREMA Randomised Clinical Trial.
Predictors of Treatment Adherence and Virological Failure Among People Living with HIV Receiving Antiretroviral Therapy in a South African Rural Community: A Sub-study of the ITREMA Randomised Clinical Trial.
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DOI：
10.1007/s10461-023-04103-2
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发表时间：
2023-12
影响因子：
4.4
通讯作者：
Hermans, Lucas E. E.
中科院分区：
文献类型：
--
作者：
Gumede, Siphamandla B. B.;Wensing, Annemarie M. J.;Lalla-Edward, Samanta T. T.;de Wit, John B. F.;Venter, W. D. Francois;Tempelman, Hugo A. A.;Hermans, Lucas E. E.
撒哈拉以南非洲的艾滋病毒携带者中，有很大一部分人居住在农村地区。在这些人群中，对抗逆转录病毒治疗(ART)的促进者和障碍的了解有限。作为临床试验(ClinicalTrials.gov NCT03357588)的子研究，我们在南非一家农村治疗机构对501名接受抗逆转录病毒治疗的成人PLHIV进行了队列研究。在96周的随访中，社会经济、心理社会和行为特征被评估为自我报告的依从性困难、次佳的药物依从性和病毒学失败的协变量。男性是所有结果的独立危险因素。食物不安全与男性的病毒学失败有关。在男性和女性中，抑郁症状与病毒学失败独立相关。家庭收入和以任务为导向的应对得分对服药依从性不佳具有保护作用。这些结果强调了低家庭收入、食品不安全和抑郁对农村地区抗逆转录病毒治疗结果的影响，并证实了之前描述的其他风险因素。认识到这些因素和有针对性的依从性支持策略可能会改善患者的健康和治疗结果。网上版载有补充材料，可在10.1007/s10461-023-04103-2查阅。
A large proportion of people living with HIV (PLHIV) in sub-Saharan Africa reside in rural areas. Knowledge of enablers and barriers of adherence to antiretroviral treatment (ART) in these populations is limited. We conducted a cohort study of 501 adult PLHIV on ART at a rural South African treatment facility as a sub-study of a clinical trial (ClinicalTrials.gov NCT03357588). Socio-economic, psychosocial and behavioral characteristics were assessed as covariates of self-reported adherence difficulties, suboptimal pill count adherence and virological failure during 96 weeks of follow-up. Male gender was an independent risk factor for all outcomes. Food insecurity was associated with virological failure in males. Depressive symptoms were independently associated with virological failure in both males and females. Household income and task-oriented coping score were protective against suboptimal pill-count adherence. These results underscore the impact of low household income, food insecurity and depression on outcomes of ART in rural settings and confirm other previously described risk factors. Recognition of these factors and targeted adherence support strategies may improve patient health and treatment outcomes. The online version contains supplementary material available at 10.1007/s10461-023-04103-2.
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DOI：
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发表时间：
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期刊：
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影响因子：
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