Prevalence and predictors of highly active antiretroviral therapy use in patients with HIV infection in the United States
Prevalence and predictors of highly active antiretroviral therapy use in patients with HIV infection in the United States
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DOI：
10.1097/00126334-200010010-00005
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发表时间：
2000-10-01
期刊：
影响因子：
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通讯作者：
Wenger, NS
中科院分区：
文献类型：
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作者：
Cunningham, WE;Markson, LE;Wenger, NS
背景资料：1996年，高效抗逆转录病毒疗法（HAART）成为艾滋病毒的标准疗法，当时的研究表明，大多数艾滋病毒感染者已开始HAART治疗，但少数群体和贫困人群的HAART使用率较低。目前尚不清楚HAART的高水平使用是否持续，或者社会经济和种族差异是否随着时间的推移而减少。目的：确定1998年1月之前接受和正在接受HAART治疗的患者比例，并评估HAART治疗的预测因素。设计和参与者：对2267名接受HIV护理的成年人进行的全国概率样本的前瞻性队列研究，这些成年人完成了基线、首次随访、1996年1月至1998年1月第二次随访。主要结果变量：第二次随访时目前使用高效抗逆转录病毒疗法的比例（1997年8月至1998年1月），与1998年1月之前和1996年12月之前任何时间使用HAART的累积比例进行对比。分析：二元和多元Logistic回归分析预测当前使用HAART的人口特征在第二次随访interview.Results的时间：曾经接受HAART的患者的比例从1996年12月的37%增加到1998年1月的71%，但只有53%的人接受HAART在第二次随访interview. Results的时间。1996年后，社会人口统计学组之间使用HAART的差异缩小，在双变量分析中，在第二次随访时，几个组仍然不太可能使用HAART：黑人，男性和女性吸毒者，女性异性恋者，受教育程度较低的人，没有保险和医疗补助保险的人，东北部的人，和那些CD 4计数大于或等于500个细胞/穆尔的患者（所有p <0.05）。使用多元逻辑回归分析，低CD 4计数（对于CD 4
Background: Highly active antiretroviral therapy (HAART) became standard for HIV in 1996, Studies at that time showed that most people infected with HIV had initiated HAART, but that members of minority groups and poor people had lower HAART use. It is not known whether high levels of HAART use have been sustained or whether socioeconomic and racial disparities have diminished over time.Objectives: To determine the proportion of patients who had received and were receiving HAART by January 1998, and to evaluate predictors of HAART receipt.Design and Participants: Prospective cohort study of a national probability sample of 2267 adults receiving HIV care who completed baseline, first follow-up, and second follow-up interviews from January 1996 to January 1998.Main outcome variables: Proportion currently using HAART at second follow-up (August 1997 to January 1998), contrasted with the cumulative proportions using HAART at any time before January 1998 and before December 1996. Analyses: Bivariate and multiple logistic regression analysis of population characteristics predicting current use of HAART at the time of the second follow-up interview.Results: The proportion of patients ever having received HAART increased from 37% in December 1996 to 71% by January 1998, but only 53% of people were receiving HAART at the time of the second follow-up interview. Differences between sociodemographic groups in ever using HAART narrowed after 1996, In bivariate analysis, several groups remained significantly less likely to be using HAART at the time of the second follow-up interview: blacks, male and female drug users, female heterosexuals, people with less education, those uninsured and insured by Medicaid, those in the Northeast, and those with CD4 counts of greater than or equal to 500 cells/mul (all p < .05). Using multiple logistic regression analysis, low CD4 count (for CD4