佛山市南海区艾滋病患者抗病毒治疗服药依从性及影响因素研究

目的了解艾滋病（AIDS）患者抗病毒治疗服药的依从性及影响因素。方法在佛山市南海区艾滋病综合防治信息管理系统中随机选择200例AIDS患者作为研究对象,对患者的服药情况、未服/漏服原因、不良反应等进行问卷调查,依照Morisky等推荐的服药依从性标准对患者服药依从性进行评定,采用单因素χ²检验和多因素Logistic回归分析筛选患者服药依从性的影响因素。结果180例患者中,服药依从者88例,依从率48.9%。患者服药时间1个月~6年,治疗方案分布中,147例（81.7%）患者的服药方案为AZT+DDI+NVP或D4T+DDI+NVP组合。药物不良反应前3位依次为头痛和头晕（27.5%）,恶心、呕吐、腹泻等胃肠反应（20.0%）,药物性皮疹和皮肤瘙痒（16.2%）。多因素Logistic回归分显示：患者文化程度、服药时间是影响AIDS患者HAART治疗服药依从性的主要因素。结论AIDS患者HAART治疗服药依从性较低,患者文化程度和服药时间是其主要影响因素。

Study on adherence to antiretroviral therapy and its influencing factors among AIDS patients in Nanhai District,Foshan City

ObjectiveTo understand the adherence to antiretroviral therapy (ART) among AIDS patients in Nanhai District, Foshan City and explore its influencing factors. MethodsTotally, 200 cases of AIDS patients were randomly selected from Nanhai District, Foshan City based on the AIDS prevention and control information management system. Their medication adherence, reasons for not-taking or missing taking medicine and adverse reactions were investigated with questionnaire. Their medication adherence was assessed in accordance with Morisky’s standard. The influencing factors were analyzed by Chi-square test and multivariate logistic regression analysis.ResultsIn 180 patients, 88 patients had medication compliance, with a compliance rate of 48.9%. Their medication time varied from 1 month to 6 years. 147 cases (81.7%) received the medication scheme of AZT+DDI+NVP or D4T+DDI+NVP combination. The top three drug adverse reactions were headache and dizziness(27.5%), gastrointestinal reactions like nausea, vomiting and diarrhea (20%), as well as drug rash and pruritus(16.2%). Multivariate logistic regression analysis showed that education background and medication time were the main factors affecting the adherence to highly active anti-retroviral therapy（HAART）among AIDS patients. ConclusionsThe medication adherence to HAART in AIDS patients in Nanhai District, Foshan City is low. Education background and medication time are the main influencing factors.