Rates and Predictors of Non-Adherence to Antiretroviral Therapy among HIV-Positive Individuals in Kenya: Results from the Second Kenya AIDS Indicator Survey, 2012.
Rates and Predictors of Non-Adherence to Antiretroviral Therapy among HIV-Positive Individuals in Kenya: Results from the Second Kenya AIDS Indicator Survey, 2012.
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DOI：
10.1371/journal.pone.0167465
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Kim AA
中科院分区：
文献类型：
--
作者：
Mukui IN;Ng'ang'a L;Williamson J;Wamicwe JN;Vakil S;Katana A;Kim AA
了解不依从抗逆转录病毒治疗（ART）的水平和相关因素是至关重要的，在设计干预措施，以改善依从性和健康结果的ART。我们评估了不依从ART的艾滋病毒感染者报告ART使用在肯尼亚的全国代表性调查。2012年肯尼亚艾滋病指标调查是2012-2013年对年龄在18个月至64岁之间的人进行的基于人口的家庭调查。收集了关于人口统计学、性行为、艾滋病毒状况和ART使用的自我报告信息。采集血液进行HIV检测，如果HIV感染，则进行CD 4和病毒载量检测。采用液相色谱-串联质谱法，使用定性抗逆转录病毒（ARV）检测试剂盒检测HIV阳性标本中是否存在抗逆转录病毒（ARV）药物。报告接受抗逆转录病毒治疗但不存在抗逆转录病毒生物标志物的艾滋病毒阳性者被定义为不依从抗逆转录病毒药物治疗。我们的分析仅限于15-64岁的HIV感染者，他们报告接受了抗逆转录病毒治疗，并有实验室确认的抗逆转录病毒检测结果。采用多变量logistic回归分析确定与不依从相关的变量。共有648人（5.6%; CI 4.9-6.3）检测为艾滋病毒阳性，其中559人（86.3%）有足够的血量进行抗逆转录病毒药物检测。其中，271（47.7%; CI 41.8-53.6）在访谈期间自我报告HIV阳性状态，186（69.1%; CI 62.2-76.0）。186名个体中有18名不存在ARV生物标志物（9.4%; CI 4.9-13.8），因此被定义为不依从ART。不依从与年龄15-29岁相关（AOR 8.39; CI 2.26-31.22，p = 0.002）与30-64岁农村居民相比（AOR 5.87; CI 1.39-25.61，p = 0.016）与过去30天内居住在城市并服用娱乐性药物相比（AOR 5.89; CI 1.30-26.70，p = 0.022）。总的来说，在接受抗逆转录病毒治疗的15-64岁肯尼亚人中，只有不到10%的人没有坚持服用艾滋病毒药物，这突出表明了肯尼亚国家抗逆转录病毒治疗计划的成功。然而，我们的研究结果指出，需要有针对性的干预措施，特别是针对年轻人，农村地区的年轻人，以改善依从性结果，以及提供包括心理社会支持在内的治疗计划，作为预防措施，以尽量减少药物滥用和治疗失败的风险。
Understanding the levels and associated factors of non-adherence to antiretroviral therapy (ART) is crucial in designing interventions to improve adherence and health outcomes of ART. We assessed non-adherence to ART among HIV-infected persons reporting ART use in a nationally representative survey in Kenya. The Kenya AIDS Indicator Survey 2012 was a population-based, household survey of persons aged 18 months-64 years conducted in 2012–2013. Self-reported information was collected on demographics, sexual behaviour, HIV status, and ART use. Blood was collected for HIV testing, and if HIV infected, CD4 and viral load testing. HIV-positive specimens were tested for the presence of antiretroviral (ARV) drugs using a qualitative ARV assay using liquid chromatography-tandem mass spectrometry. HIV-positive persons who reported receiving ART but did not have the ARV biomarker present were defined as being non-adherent to their ARV medication. We restricted our analysis to HIV-infected persons aged 15–64 years who reported receiving ART and had laboratory-confirmed results from ARV testing. Multivariate logistic regression was used to identify variables associated with non-adherence. A total of 648 (5.6%; CI 4.9–6.3) tested HIV-positive of whom 559 (86.3%) had sufficient volume of blood to be tested for ARV drugs. Of those, 271 (47.7%; CI 41.8–53.6) self-reported HIV-positive status during the interview and 186 (69.1%; CI 62.2–76.0) of those reported taking ART. The ARV biomarker was absent in 18 of 186 individuals (9.4%; CI 4.9–13.8) who thus were defined as being non-adherent to ART. Non-adherence was associated with being aged 15–29 years (AOR 8.39; CI 2.26–31.22, p = 0.002) compared to aged 30–64 years, rural residence (AOR 5.87; CI 1.39–25.61, p = 0.016) compared with urban residence and taking recreational drugs in the past 30 days (AOR 5.89; CI 1.30–26.70, p = 0.022). Overall, less than 10% of Kenyans aged 15–64 years on ART were not adhering to their HIV medication, highlighting the success of the Kenyan national ART program. Our findings, however, point to the need for targeted interventions particularly for young persons, those in rural areas to improve adherence outcomes, as well as delivery of treatment programs that include psychosocial support as a preventative measure to minimize substance abuse and the risk of treatment failure.
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影响因子：
4.5
作者：
Hansana V;Sanchaisuriya P;Durham J;Sychareun V;Chaleunvong K;Boonyaleepun S;Schelp FP
通讯作者：
Schelp FP
DOI：
10.1155/2013/873939
发表时间：
2013
期刊：
ISRN AIDS
影响因子：
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作者：
Obirikorang C;Selleh PK;Abledu JK;Fofie CO
通讯作者：
Fofie CO
影响因子：
3.7
作者：
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通讯作者：
Asiimwe A
影响因子：
3.7
作者：
Kim AA;Parekh BS;Umuro M;Galgalo T;Bunnell R;Makokha E;Dobbs T;Murithi P;Muraguri N;De Cock KM;Mermin J;2007 KAIS study group
通讯作者：
2007 KAIS study group
影响因子：
168.9
作者：
Lester, Richard T.;Ritvo, Paul;Plummer, Francis A.
通讯作者：
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