Understanding HIV-Related Pill Aversion as a Distinct Barrier to Medication Adherence
Understanding HIV-Related Pill Aversion as a Distinct Barrier to Medication Adherence
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DOI：
10.1080/08964289.2018.1534076
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发表时间：
2019-10-02
影响因子：
2.3
通讯作者：
Yee, Lynn M.
中科院分区：
文献类型：
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作者：
Dorman, Robin M.;Sutton, Sarah H.;Yee, Lynn M.
避孕药厌恶，被定义为在没有可识别的医疗原因的情况下难以吞咽药物，对于许多艾滋病毒感染者来说，这是一个难以持续抑制病毒的障碍。我们的目标是量化自我报告的避孕药厌恶的频率，描述其症状，并测量自我报告的避孕药厌恶与错过抗逆转录病毒剂量之间的关联。这是一项前瞻性的、观察性的、探索性的调查研究，对象是一家城市三级门诊的英语艾滋病毒携带者(PLHIV)。参与者完成了关于他们吞下抗逆转录病毒药物经历的匿名问卷调查。主要结果是由于避孕药厌恶症状而不服药。在384名参与者中，四分之一(25.5%)的人因避孕药厌恶症状而不服药。年龄较小、非西班牙裔黑人或西班牙裔、未婚或未婚、没有公共保险、没有就业、大学教育程度不足以及有精神健康诊断与因避孕药厌恶而跳过药物有关。在多变量回归分析中，不吃药的PLHIV患者更有可能报告口吃、吞咽时恶心和胃部沉重的症状，以及被药片的味道、气味和大小困扰。与不因避孕药而不服药的PLHIV相比，不服药的PLHIV也更有可能报告对服药的负面和基于恐惧的情绪。艾滋病毒相关的避孕药厌恶可能是成人艾滋病毒人群中坚持服药的一个重要和频繁的障碍。
Pill aversion, defined as difficulty swallowing pills without identifiable medical cause, is a poorly characterized barrier to sustained viral suppression for many HIV-infected persons. We aimed to quantify the frequency of self-reported pill aversion, characterize its symptoms, and measure the association between self-reported pill aversion and missing antiretroviral doses. This is a prospective, observational, exploratory survey study of English-speaking persons living with HIV (PLHIV) at a single urban tertiary outpatient clinic. Participants completed anonymous questionnaires about their experiences of swallowing antiretroviral pills. The primary outcome was skipping pills due to pill aversion symptoms. Of 384 participants, a quarter (25.5%) skipped pills due to pill aversion symptoms. Younger age, being Non-Hispanic Black or Hispanic, not being married or partnered, having public insurance, not being employed, having less than a college education, and having a mental health diagnosis were associated with skipping pills due to pill aversion. On multivariable regression analyses, PLHIV who skipped pills were more likely to report symptoms of gagging, nausea at the time of swallowing, and heavy feeling in the stomach, as well as being bothered by the taste, smell, and size of the pills. PLHIV who skipped pills were also more likely to report negative and fear-based emotions about pill-taking than PLHIV who did not skip pills due to pill aversion. HIV-related pill aversion may represent a significant and frequent barrier to adherence in an adult HIV population.