Psychosocial Factors Affecting Medication Adherence Among HIV-1 Infected Adults Receiving Combination Antiretroviral Therapy (cART) in Botswana
Psychosocial Factors Affecting Medication Adherence Among HIV-1 Infected Adults Receiving Combination Antiretroviral Therapy (cART) in Botswana
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DOI：
10.1089/aid.2009.0222
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发表时间：
2010-06-01
影响因子：
1.5
通讯作者：
Wester, C. William
中科院分区：
文献类型：
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作者：
Do, Natalie T.;Phiri, Kelesitse;Wester, C. William
随着撒哈拉以南非洲越来越多的人接受可能挽救生命的抗逆转录病毒联合疗法，必须确定可能影响抗逆转录病毒药物治疗依从性的社会心理因素。使用87个问题的调查，从博茨瓦纳接受cART治疗的患者中收集以下数据：人口统计学、表现（Karnofsky）评分、感知的耻辱感和艾滋病毒披露水平、对艾滋病毒/艾滋病的态度和信念、物质和/或药物使用、抑郁症以及药房和医疗保健提供者相关因素。总体依从率由患者自我报告、机构依从性和文化修改的Morisky量表确定。2005年4月至5月期间招募了300名成年患者。基于4天和1个月患者召回以及前3个月内ARV药物补充的门诊就诊率，总体cART依从率为81.3%。接受cART治疗1-6个月的成人的依从性最低（77%），其次是接受cART治疗超过12个月的成人（79%）。饮酒、抑郁和未向伴侣透露HIV阳性状态是依从率低的预测因素（p值
As increasing numbers of persons are placed on potentially life-saving combination antiretroviral therapy (cART) in sub-Saharan Africa, it is imperative to identify the psychosocial and social factors that may influence antiretroviral (ARV) medication adherence. Using an 87 question survey, the following data were collected from patients on cART in Botswana: demographics, performance (Karnofsky) score, perceived stigma and level of HIV disclosure, attitudes and beliefs concerning HIV/AIDS, substance and/or drug use, depression, and pharmacy and healthcare provider-related factors. Overall adherence rates were determined by patient self-report, institutional adherence, and a culturally modified Morisky scale. Three hundred adult patients were recruited between April and May 2005. The overall cART adherence rate was 81.3% based on 4 day and 1 month patient recall and on clinic attendance for ARV medication refills during the previous 3 months. Adults receiving cART for 1-6 months were the least adherent (77%) followed by those receiving cART for greater than 12 months (79%). Alcohol use, depression, and nondisclosure of positive HIV status to their partner were predictive of poor adherence rates (p value