Social grants for people living with HIV and on antiretroviral therapy in KwaZulu-Natal, South Africa: a longitudinal study
Social grants for people living with HIV and on antiretroviral therapy in KwaZulu-Natal, South Africa: a longitudinal study
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DOI：
10.1080/17290376.2012.665253
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发表时间：
2012-03-01
影响因子：
1.1
通讯作者：
Peltzer, Karl
中科院分区：
文献类型：
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作者：
Peltzer, Karl
本研究的目的是评估残疾补助金（DG）状态和DG对艾滋病毒患者的健康结果和抗逆转录病毒治疗（ART）的影响，在南非夸祖鲁-纳塔尔的纵向研究超过20个月的预测。传染病患者，735人（29.8%的男性和70.2%的女性）完成了评估（采用结构化问卷和医疗档案审查）开始抗逆转录病毒治疗前，6个月后519例，12个月后557例，20个月后499例。结果表明，发现大量HIV或ART患者接受DG，随着接受抗逆转录病毒治疗的时间的推移，这一比例显著下降（从接受抗逆转录病毒治疗6个月时的52.3%下降到接受抗逆转录病毒治疗20个月时的9.8%）。在不同的阶段，在收到DG被发现与不被雇用，更高的生活质量（QoL），年龄较大，更高的酒精使用分数，没有正式的工资作为家庭收入和更高的主观健康状况的多变量分析。在评估期间，大量患者失去了DG状态，未发现与主要健康结局（CD4细胞计数，坚持ART和HIV症状）相关。在多元回归广义估计方程模型中，未接受DG、健康相关的生活质量、较低的HIV症状和较低的抑郁评分与CD4计数相关。艾滋病病毒感染者不再符合领取补助金的资格，但没有足够的经济能力满足基本需要，应参加营养支持计划。
The aim of this study was to assess the predictors of the receipt of a disability grant (DG) status and the impact of the DG on health outcomes of HIV patients and on antiretroviral therapy (ART) in a longitudinal study over 20 months in KwaZulu-Natal, South Africa. Consecutive patients, 735 (29.8% males and 70.2% females), who attended three HIV clinics completed the assessments (with a structured questionnaire and medical file review) prior to antiretroviral initiation, 519 after 6 months, 557 after 12 months and 499 after 20 months on ART. The results indicate that a large number of HIV or ART patients were found to be in receipt of a DG, which declined significantly over the time of being on ART (from 52.3% at 6 months on ART to 9.8% at 20 months on ART). At various stages, being in receipt of a DG was found to be associated with not being employed, higher quality of life (QoL), older age, higher alcohol use score, no formal salary as household income and higher subjective health status in multivariable analyses. A significant number of patients lost their DG status over the assessment period, which was not found to be associated with major health outcomes (CD4 cell counts, adherence to ART and HIV symptoms). In a multiple regression generalized estimating equation model, not being in receipt of a DG, health-related QoL, lower HIV symptoms and lower depression scores were associated with CD4 counts. HIV patients who no longer qualify for the DG and yet do not have adequate financial means to meet basic necessities should be put on a nutritional support programme.