Antiretroviral drug diversion links social vulnerability to poor medication adherence in substance abusing populations.
Antiretroviral drug diversion links social vulnerability to poor medication adherence in substance abusing populations.
复制标题
DOI：
10.1007/s10461-014-0969-7
复制
发表时间：
2015-05
影响因子：
4.4
通讯作者：
Surratt, Hilary L.
中科院分区：
文献类型：
--
作者：
Tsuyuki, Kiyomi;Surratt, Hilary L.
南佛罗里达州记录了将抗逆转录病毒(ARV)药物转移到非法市场的情况，并与艾滋病毒携带者的依从性不佳有关。抗逆转录病毒药物的转移反映了弱势人群对护理的需求未得到满足，这些人群由于相互竞争的需求和共病，难以进行持续的艾滋病毒护理。这项研究应用Gelberg-Andersen针对弱势人群的卫生保健利用行为模型来理解社会脆弱性如何与抗逆转录病毒药物的转移和坚持联系在一起。横断面数据是从2010年至2012年南佛罗里达州艾滋病毒携带者的目标样本中收集的(n=503)。结构化访谈收集了有关抗逆转录病毒药物转移、护理的获取和利用以及抗逆转录病毒药物依从性的定量数据。Logistic回归被用来估计测试领域匹配的加性模型的拟合优度。用线性回归估计社会脆弱性和抗逆转录病毒转移对抗逆转录病毒治疗依从性的影响。预测抗逆转录病毒转移的最佳模型将月收入低和不稳定的艾滋病毒护理确定为促进抗逆转录病毒转移的显著促成因素。重要的是，卫生保健需求因素并不能防止抗逆转录病毒病毒的转移，这表明即使在该样本健康状况不佳的情况下，也会优先考虑直接的竞争需求。我们还发现，ARV转移在社会脆弱性和次优ARV依从性之间提供了联系，ARV转移和行为模型中的领域解释了ARV依从性的25%的变化。我们的分析显示，迫切需要通过加强有利因素(例如，患者与提供者的关系)来改善弱势人群对艾滋病毒护理的参与度，以改善弱势人群对艾滋病毒护理的保留和对抗逆转录病毒药物的遵守。
Antiretroviral (ARV) medication diversion to the illicit market has been documented in South Florida, and linked to sub-optimal adherence in people living with HIV. ARV diversion reflects an unmet need for care in vulnerable populations that have difficulty engaging in consistent HIV care due to competing needs and co-morbidities. This study applies the Gelberg-Andersen Behavioral Model of Health Care Utilization for Vulnerable Populations to understand how social vulnerability is linked to ARV diversion and adherence. Cross-sectional data were collected from a targeted sample of vulnerable people living with HIV in South Florida between 2010 and 2012 (n=503). Structured interviews collected quantitative data on ARV diversion, access and utilization of care, and ARV adherence. Logistic regression was used to estimate the goodness-of-fit of additive models that test domain fit. Linear regression was used to estimate the effects of social vulnerability and ARV diversion on ARV adherence. The best fitting model to predict ARV diversion identifies having a low monthly income and unstable HIV care as salient enabling factors that promote ARV diversion. Importantly, health care need factors did not protect against ARV diversion, evidence that immediate competing needs are prioritized even in the face of poor health for this sample. We also find that ARV diversion provides a link between social vulnerability and sub-optimal ARV adherence, with ARV diversion and domains from the Behavioral Model explaining 25% of the variation in ARV adherence. Our analyses reveal great need to improve engagement in HIV care for vulnerable populations by strengthening enabling factors (e.g. patient-provider relationship) to improve retention in HIV care and ARV adherence for vulnerable populations.
登录
查看更多内容
影响因子：
3.8
作者：
Bangsberg, DR;Perry, S;Moss, A
通讯作者：
Moss, A
影响因子：
5
作者：
ANDERSEN, RM
通讯作者：
ANDERSEN, RM
DOI：
10.1097/00042560-199806010-00003
发表时间：
1998-06-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Eldred, LJ;Wu, AW;Moore, RD
通讯作者：
Moore, RD
影响因子：
--
作者：
Bing, EG;Burnam, A;Shapiro, M
通讯作者：
Shapiro, M
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