Adherence to highly active antiretroviral therapy in Hyderabad, India: barriers, facilitators and identification of target groups
Adherence to highly active antiretroviral therapy in Hyderabad, India: barriers, facilitators and identification of target groups
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DOI：
10.1177/0956462415578545
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发表时间：
2016-03-01
影响因子：
1.4
通讯作者：
Chakraborty, Apurba
中科院分区：
文献类型：
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作者：
Dworkin, Mark S.;Douglas, G. W.;Chakraborty, Apurba
我们评估了印度海得拉巴艾滋病患者坚持高效抗逆转录病毒治疗的障碍和促进因素，并确定了其患病率。我们在接受高效抗逆转录病毒治疗并接受九家诊所护理的艾滋病毒感染成年人中进行了一项横断面研究。抑郁症进行了筛选，使用患者健康问卷9和艾滋病毒药物依从性的促进者进行了评估，使用11项量表，产生了一个总的积极态度的疾病评分。计算不同类别潜在危险因素之间的不依从性患病率。我们比较了依从性和非依从性人群的平均依从性促进因子得分。多变量泊松回归稳健方差用于识别独立的危险因素。在211名受访者中，近20%为非依从性，约8%患有中度或重度抑郁症，药物依从性联合促进者的平均得分为33.35（+/- 7.88），满分为44分。与不依从性显著相关的因素包括年龄较大、女性性工作者、中度至重度抑郁和药物依从性综合促进因子评分。这些来自海得拉巴广泛临床环境的数据表明，坚持干预的重点群体是女性性工作者，老年人和抑郁症患者。
We assessed the barriers and facilitators to highly active antiretroviral therapy adherence and determined their prevalence among HIV/AIDS patients in Hyderabad, India. We conducted a cross-sectional study among HIV-infected adults prescribed highly active antiretroviral therapy and receiving care from nine clinics. Depression was screened using Patient Health Questionnaire 9 and facilitators of HIV medication adherence were assessed using an 11-item scale which yielded a total positive attitude to disease score. Prevalence ratios of non-adherence between different categories of potential risk factors were calculated. We compared mean facilitators to adherence' scores between the adherent and non-adherent population. Multivariable Poisson regression with robust variance was used to identify independent risk factors. Among the 211 respondents, nearly 20% were non-adherent, approximately 8% had either moderately severe or severe depression and mean score for combined facilitators to medication adherence was 33.35 (+/- 7.88) out of a possible 44 points. Factors significantly associated with non-adherence included older age, female sex worker, moderate-to-severe depression and the combined facilitators to medication adherence score. These data from a broad range of clinical settings in Hyderabad reveal that key groups to focus on for adherence intervention are female sex workers, older persons and those with depression.