The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons.
The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons.
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DOI：
10.1007/s10461-015-1198-4
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发表时间：
2016-05
影响因子：
4.4
通讯作者：
Altice FL
中科院分区：
文献类型：
--
作者：
Culbert GJ;Bazazi AR;Waluyo A;Murni A;Muchransyah AP;Iriyanti M;Finnahari;Polonsky M;Levy J;Altice FL
对艾滋病毒药物的消极态度可能会限制印尼监狱中抗逆转录病毒疗法(ART)的使用，许多艾滋病毒携带者(PLH)在那里被诊断并首次接受抗逆转录病毒疗法。这项混合方法的研究考察了药物态度对感染艾滋病毒的印度尼西亚囚犯使用抗逆转录病毒药物的影响。随机选择的感染艾滋病毒的男性囚犯(n=102)完成了面对面的深入访谈和评估ART态度的结构化调查。结果显示，尽管有一半的参与者使用了抗逆转录病毒治疗，但在符合抗逆转录病毒治疗资格指南的人中，有四分之一没有使用。没有使用抗逆转录病毒疗法的参与者赞同对抗逆转录病毒疗法的有效性、安全性和不良反应的更多担忧，并更确定地认为，对于感觉健康的PLH患者，抗逆转录病毒疗法应该推迟。在多因素分析中，抗逆转录病毒治疗的使用与更积极的抗逆转录病毒治疗态度(AOR=1.09，95%CI1.03-1.16，p=0.002)和更高的内在化艾滋病毒污名(AOR=1.03，95%CI1.00-1.07，p=0.016)独立相关。需要对艺术进行社会营销，以抵消限制印尼囚犯使用艺术的负面态度。
Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03–1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00–1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.