Demographic, Psychological, and Behavioral Modifiers of the Antiretroviral Treatment Access Study (ARTAS) Intervention
Demographic, Psychological, and Behavioral Modifiers of the Antiretroviral Treatment Access Study (ARTAS) Intervention
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DOI：
10.1089/apc.2008.0262
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发表时间：
2009-09-01
影响因子：
4.9
通讯作者：
del Rio, Carlos
中科院分区：
文献类型：
--
作者：
Gardner, Lytt I.;Marks, Gary;del Rio, Carlos
本研究试图确定抗逆转录病毒治疗准入研究(ARTAS)干预在将新近确诊的艾滋病毒阳性者与医疗服务联系起来方面具有更强或更弱效果的人口、结构、行为和心理亚群。这项从2001年到2003年进行的研究随机选择了316名参与者，让他们接受被动转介或基于优势的关联干预，以促进进入艾滋病毒初级保健。结果是在连续两个6个月的期间中，每年至少参加一次艾滋病毒初级保健访问。参与者(71%的男性；29%的西班牙裔；57%的非西班牙裔黑人)来自美国四个城市的性传播疾病诊所、医院和社区组织。在基线上测量的13个效应修正变量被检查。在未调整和已调整的对数线性回归模型中，使用交互作用项对亚组差异进行正式检验。86%(273/316)的参与者有完整的12个月随访数据。干预显著改善了26个亚组中的12个亚组与护理的联系。在效果修正的多变量分析中，拉美裔美国人的干预显著(p<；0.05)强于其他种族/民族的总和，不稳定住房的人比稳定住房的人更强，没有抑郁症状的人比有抑郁症状的人更强。ARTAS连锁干预在许多但不是所有最近被诊断为艾滋病毒感染者的亚群中是成功的。在三个变量中，一个亚组的干预效果明显强于对应的亚组。为了扩大其范围，干预可能需要针对那些对干预反应不佳的群体的具体需求进行调整。
The present study sought to identify demographic, structural, behavioral, and psychological subgroups for which the Antiretroviral Treatment Access Study (ARTAS) intervention had stronger or weaker effects in linking recently diagnosed HIV-positive persons to medical care. The study, carried out from 2001 to 2003, randomized 316 participants to receive either passive referral or a strengths-based linkage intervention to facilitate entry into HIV primary care. The outcome was attending at least one HIV primary care visit in each of two consecutive 6-month periods. Participants (71% male; 29% Hispanic; 57% black non-Hispanic), were recruited from sexually transmitted disease clinics, hospitals and community-based organizations in four U. S. cities. Thirteen effect modifier variables measured at baseline were examined. Subgroup differences were formally tested with interaction terms in unadjusted and adjusted log-linear regression models. Eighty-six percent (273/316) of participants had complete 12-month follow-up data. The intervention significantly improved linkage to care in 12 of 26 subgroups. In multivariate analysis of effect modification, the intervention was significantly (p < 0.05) stronger among Hispanics than other racial/ethnic groups combined, stronger among those with unstable than stable housing, and stronger among those who were not experiencing depressive symptoms compared to those who were. The ARTAS linkage intervention was successful in many but not all subgroups of persons recently diagnosed with HIV infection. For three variables, the intervention effect was significantly stronger in one subgroup compared to the counterpart subgroup. To increase its scope, the intervention may need to be tailored to the specific needs of groups that did not respond well to the intervention.