Alcohol use, antiretroviral therapy adherence, and preferences regarding an alcohol-focused adherence intervention in patients with human immunodeficiency virus.
Alcohol use, antiretroviral therapy adherence, and preferences regarding an alcohol-focused adherence intervention in patients with human immunodeficiency virus.
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DOI：
10.2147/ppa.s55547
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发表时间：
2014
影响因子：
2.2
通讯作者：
Morojele NK
中科院分区：
文献类型：
--
作者：
Kekwaletswe CT;Morojele NK
这项研究的主要目的是确定酒精与抗逆转录病毒疗法(ART)依从性之间的联系，以及依从性咨询计划元素的感知适当性和可接受性，重点是南非茨瓦内人类免疫缺陷病毒(HIV)诊所接受抗逆转录病毒疗法(ART)的受试者中与酒精相关的ART不依从性。我们进行了一项有目的抽样的横断面研究。样本包括两个艾滋病救济支持的艾滋病毒诊所总统紧急计划的304名男性和女性抗逆转录病毒治疗接受者。通过访谈计划，我们评估了患者的酒精使用(酒精使用障碍鉴定测试)、其他药物使用、对抗逆转录病毒治疗的依从性水平以及错过抗逆转录病毒药物剂量的原因(艾滋病临床试验小组依从性仪器)。此外，还就以下问题征求了患者的意见：潜在促进者的可能有效性；会议的首选数量、持续时间、形式和设置；让家人/朋友与患者一起参加会议的用处；以及需要传授的潜在技能。大约一半的男性饮酒者和四分之三的女性饮酒者的酒精使用障碍识别测试分数暗示着危险或有害的饮酒。平均自我报告的ART依从率为89.7%。酒精使用水平和对ART的坚持程度之间存在显著关联。总体而言，参与者认为两次以诊所为基础的会议，每次持续一小时，以小组形式进行，并由同伴或遵约顾问协助，是最合适和可接受的。参与者对陪同他们参加会议的家人和朋友也持好感。他们还支持以酒精为重点的遵从性咨询计划，该计划采用了激励性访谈和认知行为疗法类型的方法。酒精使用和ART不依从性之间的关联表明有必要进行以酒精为重点的ART依从性干预。患者的认知表明，他们愿意接受以临床为基础的简短激励性访谈和由外行人在小组环境中提供的认知行为疗法类型的依从性干预。进一步的研究应调查如何在现有卫生系统中最好地实施这种干预措施。
The primary objectives of this study were to determine the association between alcohol and antiretroviral therapy (ART) adherence and the perceived appropriateness and acceptability of elements of an adherence counseling program with a focus on alcohol-related ART nonadherence among a sample of ART recipients in human immunodeficiency virus (HIV) clinics in Tshwane, South Africa. We conducted a cross-sectional study with purposive sampling. The sample comprised 304 male and female ART recipients at two President’s Emergency Plan For AIDS Relief-supported HIV clinics. Using an interview schedule, we assessed patients’ alcohol use (Alcohol Use Disorders Identification Test), other drug use, level of adherence to ART, and reasons for missing ART doses (AIDS Clinical Trials Group adherence instrument). Additionally, patients’ views were solicited on: the likely effectiveness of potential facilitators; the preferred quantity, duration, format, and setting of the sessions; the usefulness of having family members/friends attend sessions along with the patient; and potential skill sets to be imparted. About half of the male drinkers’ and three quarters of the female drinkers’ Alcohol Use Disorders Identification Test scores were suggestive of hazardous or harmful drinking. Average self-reported ART adherence was 89.7%. There was a significant association between level of alcohol use and degree of ART adherence. Overall, participants perceived two clinic-based sessions, each of one hour’s duration, in a group format, and facilitated by a peer or adherence counselor, as most appropriate and acceptable. Participants also had a favorable attitude towards family and friends accompanying them to the sessions. They also favored an alcohol-focused adherence counseling program that employs motivational interviewing and cognitive behavioral therapy-type approaches. The association between alcohol use and ART nonadherence points to a need for alcohol-focused ART adherence interventions. Patients’ perceptions suggest their amenability to clinic-based brief motivational interviewing and cognitive behavioral therapy-type adherence interventions delivered by lay persons in group settings. Further research should investigate how best to implement such interventions in the existing health system.