Family support, discrimination, and quality of life among ART-treated HIV-infected patients: a two-year study in China.
Family support, discrimination, and quality of life among ART-treated HIV-infected patients: a two-year study in China.
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DOI：
10.1186/s40249-017-0364-5
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发表时间：
2017-11-21
影响因子：
8.1
通讯作者：
Cheng F
中科院分区：
文献类型：
--
作者：
Xu JF;Ming ZQ;Zhang YQ;Wang PC;Jing J;Cheng F
截至2016年9月，中国约有653，865人感染艾滋病毒/艾滋病（PLWHA），492，725人正在接受抗逆转录病毒治疗（ART）。艾滋病毒/艾滋病感染者经常在个人和社会生活的各个领域受到歧视。世界卫生组织将歧视列入其与不良身心健康有关的健康因素的社会决定因素清单。本文旨在探讨中国HIV感染者在接受抗逆转录病毒治疗过程中所享受的家庭支持和所面临的歧视，以及它们对患者生活质量的影响。我们从2010年开始，在广西省接受ART治疗的HIV患者中进行了这项观察性队列研究，在基线、6、12和24个月时进行了问卷调查。描述性分析用于描述人口统计学特征（例如，年龄、性别、教育程度、婚姻状况和就业状况）。采用广义估计方程（GEE）研究家庭支持、歧视与生活质量的关系。在这项研究中，90.4%（n = 281）的患者在基线时接受了家庭支持，这里定义为开始ART，91.8%（n = 244）在ART 6个月时接受了家庭支持，95.5%（n = 220）在12个月时接受了家庭支持，94.3%（n = 230）在24个月时接受了家庭支持。基线时，未感觉受到家人歧视的患者比例为87.2%（n = 274），ART治疗6个月时为90.4%（n = 229），12个月时为90.0%（n = 210），24个月时为94.5%（n = 219）。患者的总体生活质量评分与接受家庭支持呈正相关（OR = 2.74，P = 0.040，95%CI：1.68-4.47），未感受到家庭歧视（OR = 1.3，P = 0.041，95% CI：1.07-1.59）或患者本身的歧视，包括从未经历过被家人遗弃的恐惧（OR = 2.05，P = 0.025，95%CI：1.49-2.82）。研究发现，没有歧视或歧视最小的家庭支持沿着有助于艾滋病毒感染者的生活质量。随着ART的继续，他们的总体生活质量趋于显著改善。这表明政策制定者和研究人员都应该探讨旨在改善和加强家庭支持、照顾艾滋病毒感染者和艾滋病患者以及促进高危人群艾滋病毒筛查的战略。本文的在线版本（10.1186/s40249-017-0364-5）包含补充材料，可供授权用户使用。
By September 2016, approximately 653,865 people in China were living with HIV/AIDS (PLWHA) and 492,725 people were receiving antiretroviral therapy (ART). PLWHA frequently experience discrimination in all domains of their personal and social lives. The World Health Organization includes discrimination in its list of social determinants of health factors that have been linked to poor physical and psychological health. This paper identifies the family support enjoyed and discrimination faced by people infected with HIV and examines the effect they have on patients’ quality of life (QOL) as they undergo ART in China. We conducted this observational cohort study of ART-treated patients with HIV in Guangxi Province using a questionnaire survey at baseline, 6, 12, and 24 months, starting in 2010. Descriptive analysis was used to describe the demographic characteristics (e.g., age, sex, educational level, marital status, and employment status) of participants. Generalized estimating equations (GEE) were employed to examine the relationships between family support, discrimination, and QOL. In the study, 90.4% (n = 281) of patients received family support at baseline, here defined as the initiation of ART, 91.8% (n = 244) received family support 6 months into ART, 95.5% (n = 220) at 12 months, and 94.3% (n = 230) at 24 months. The proportion of patients who did not feel discriminated against by their families was 87.2% (n = 274) at baseline, 90.4% (n = 229) 6 months into ART, 90.0% (n = 210) at 12 months, and 94.5% (n = 219) at 24 months. Patients’ overall QOL scores were positively associated with having received family support (OR = 2.74, P = 0.040, 95% CI: 1.68–4.47), not feeling discriminated against by their families (OR = 1.3, P = 0.041, 95% CI: 1.07–1.59) or discrimination from patients themselves, including never experiencing fear of abandonment by family (OR = 2.05, P = 0.025, 95% CI: 1.49–2.82). Family support along with no or minimal discrimination was found to contribute to QOL among people infected with HIV. Their overall QOL tended to improve significantly as ART continued. This suggests that strategies meant to improve and strengthen family support, care for PLWHA, and promote HIV screening among high-risk populations should be explored by both policy makers and researchers. The online version of this article (10.1186/s40249-017-0364-5) contains supplementary material, which is available to authorized users.
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