Nonadherence among HIV-Infected injecting drug users: The impact of social instability
Nonadherence among HIV-Infected injecting drug users: The impact of social instability
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DOI：
10.1097/00126334-200212153-00013
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发表时间：
2002-12-15
影响因子：
3.6
通讯作者：
Spire, B
中科院分区：
文献类型：
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作者：
Bouhnik, AD;Chesney, M;Spire, B
作者测试了社会不稳定对通过注射吸毒感染 HIV 的患者（IDU；MANIF2000 队列）坚持高效抗逆转录病毒治疗 (HAART) 的影响。在研究中，他们分析了社会人口学基线特征，以制定社会不稳定指标。在 2 年随访期间通过问卷收集有关 HAART 依从性的信息。在两个不同的组中研究了与不依从性相关的因素：1）已停止注射吸毒的患者（前IDU）并且在整个随访期间未参加药物维持计划（DMT）的患者，以及2）仍然依赖阿片类药物的患者。在 210 名符合条件的患者中，114 名被归类为前吸毒者，96 名被归类为阿片类药物依赖者。前吸毒者在 384 次就诊中，有 96 次报告有不依从行为 (25.0%)，而阿片类药物依赖患者在 308 次就诊中，有 11 次不依从行为 (36.0%；p = .02)。在吸毒前吸毒者中，与不依从行为相关的唯一因素是社会不稳定，而在阿片类药物依赖患者中，注射行为是不依从行为的唯一决定因素。对于阿片类药物依赖患者，DMT 可以提高 HAART 的依从性，但前提是它能成功减少注射滥用。对于吸毒前吸毒者来说，考虑社会困难的管理以提高 HAART 的依从性非常重要。
The authors tested the impact of social instability on adherence to highly active antiretroviral therapy (HAART) among patients infected with HIV through injection drug use (IDU; MANIF2000 cohort). In the study, they analyzed sociodemographic baseline characteristics to develop an indicator of social instability. Information concerning adherence to HAART was collected through questionnaires during a 2-year follow-up period. Factors associated with nonadherence were studied in two different groups: 1) patients who had stopped injection drug use (ex-IDUs) and who were not in drug maintenance programs (DMT) during the entire follow-up period, and 2) those who were still opiate dependent. Among the 210 eligible patients, 114 were classified as ex-IDUs and 96 as opiate dependent. Ex-IDUs reported nonadherence behaviors in 96 of 384 visits (25.0%), while opiate-dependent patients were nonadherent in I I I of 308 visits (36.0%; p = .02). Among ex-IDUs, the only factor associated with nonadherence was social instability, while among opiate-dependent patients, injection behavior was the only determinant of nonadherence behavior. For opiate-dependent patients, DMT may enhance adherence to HAART, but only if it is successful in reducing abuse of injection practices. For ex-IDUs, it is very important that the management of social difficulties be taken into account to increase adherence to HAART.