Longitudinal Antiretroviral Adherence in HIV plus Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time
Longitudinal Antiretroviral Adherence in HIV plus Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time
复制标题
DOI：
10.1007/s10461-009-9546-x
复制
发表时间：
2009-06-01
影响因子：
4.4
通讯作者：
Bangsberg, David R.
中科院分区：
文献类型：
--
作者：
Byakika-Tusiime, Jayne;Crane, Johanna;Bangsberg, David R.
我们进行了一项研究，评估以家庭为基础的治疗对参加乌干达坎帕拉“母婴传播+”项目的艾滋病毒感染父母及其感染艾滋病毒的儿童的依从性的影响。依从性通过家庭用药计数和自我报告进行评估。平均依从性超过94%。多变量分析显示，抑郁症与不完全依从性相关。依从性随着时间的推移而下降。定性访谈显示，缺乏运输资金，耻辱，临床反应治疗，药物包装和治疗费用可能会影响依从性。我们的研究结果表明，向家庭中所有符合条件的艾滋病毒感染者提供抗逆转录病毒治疗与父母和儿童的良好依从性有关。即使患者接受免费治疗，新父母对抗逆转录病毒治疗的依从性也会随着时间的推移而下降。抑郁应该作为坚持治疗的潜在障碍加以解决。需要进一步的研究来评估这种家庭治疗模式在资源有限的情况下对抗逆转录病毒治疗依从性的长期影响。
We conducted a study to assess the effect of family-based treatment on adherence amongst HIV-infected parents and their HIV-infected children attending the Mother-To-Child-Transmission Plus program in Kampala, Uganda. Adherence was assessed using home-based pill counts and self-report. Mean adherence was over 94%. Depression was associated with incomplete adherence on multivariable analysis. Adherence declined over time. Qualitative interviews revealed lack of transportation money, stigma, clinical response to therapy, drug packaging, and cost of therapy may impact adherence. Our results indicate that providing ART to all eligible HIV-infected members in a household is associated with excellent adherence in both parents and children. Adherence to ART among new parents declines over time, even when patients receive treatment at no cost. Depression should be addressed as a potential barrier to adherence. Further study is necessary to assess the long-term impact of this family treatment model on adherence to ART in resource-limited settings.