Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV
Factors associated with adherence to highly active antiretroviral therapy in homeless or unstably housed adults living with HIV
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DOI：
10.1080/09540120802270250
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发表时间：
2009-01-01
影响因子：
1.7
通讯作者：
Stall, Ron
中科院分区：
文献类型：
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作者：
Royal, Scott W.;Kidder, Daniel P.;Stall, Ron
本研究的目的是调查坚持高活性抗逆转录病毒治疗（HAART）的人与艾滋病毒/艾滋病（PLWHA）谁是无家可归或不稳定的住房。我们评估了美国三个城市中无家可归或居住不稳定的PLWHA（n=644），这些人参加了住房和健康研究。使用基线数据并控制性别，种族，年龄和教育程度，我们研究了自我报告的两天和七天坚持与获得医疗保健，心理健康，物质使用和对HIV药物治疗的态度之间的关联。在644名参与者中，358名（55%）目前正在接受HAART治疗。对于2天依从性，280例（78%）报告未缺失处方剂量（100%依从性），对于7天依从性，291例（81%）报告90%依从性。逻辑回归分析表明，年轻，没有健康保险和药物使用与过去两天内丢失1剂药物有关。SF-36精神成分汇总量表评分较低，抑郁（CES-D）和压力（感知压力量表）风险较高，与2天和7天结局的依从性较差相关。对艾滋病毒治疗的消极态度也与较低的依从性有关。这一人群对艾滋病毒药物的依从性与其他人群相似。同时存在的获得医疗保健的问题、精神健康问题的风险较高以及对治疗的态度较差沿着，与漏服剂量的可能性增加有关。艾滋病毒护理的综合模式，包括一个连续的医疗和社会服务，是治疗这一人群的关键。
The aim of this study is to investigate adherence to highly active antiretroviral therapy (HAART) in persons living with HIV/AIDS (PLWHA) who are homeless or unstably housed. We evaluated homeless or unstably housed PLWHA (n=644) in three US cities were enrolled in the Housing and Health Study. Using baseline data and controlling for gender, race, age, and education, we examined associations between self-reported two- and Seven-day adherence and access to healthcare, mental health, substance use, and attitudes toward HIV medical therapy. Of the 644 participants, 358 (55%) were currently on HAART. For two-day adherence, 280 (78%) reported missing no prescribed doses (100% adherence), and for seven-day adherence, 291 (81%) reported 90% adherence. Logistic regression analyses indicated being younger, not having health insurance, and drug use were associated with missing 1 dose over the past two days. Scoring lower on SF-36 mental component summary scale and having greater risk of depression (CES-D) and stress (Perceived Stress Scale) were associated with poorer adherence for both two- and seven-day outcomes. Negative attitudes toward HIV treatment were also associated with lower adherence. Adherence to HIV medications in this population is similar to other groups. Coexisting problems of access to healthcare, higher risk of mental health problems, along with poorer attitudes toward treatment are associated with increased likelihood of missing doses. Comprehensive models of HIV care that include a continuum of medical and social services are essential for treating this population.