395例HIV/AIDS病人未进行抗病毒治疗的原因分析

目的探讨影响符合抗病毒治疗条件的艾滋病病毒（HIV）感染者/艾滋病（AIDS）病人（HIV/AIDS病人）未进行抗病毒治疗的原因。方法采用横断面调查方法,根据设计好的调查问卷,对广西A区、河南B县和云南C市3个调查点内符合条件的395例HIV/AIDS病例进行问卷调查,将未治疗原因进行分类统计。结果调查对象选择的未治疗的原因主要有8种,可分为主观原因和客观原因两类,其中主观原因占大多数（62.5%）,且均排在前6位;第1位未治疗原因是＂自觉健康状况良好＂（48.1%）,该原因在3个调查点中均排在第1位,选择该原因的调查对象大多数（61.1%）没有出现AIDS临床症状,而且CD4T淋巴细胞计数检测结果也相对较高,在200～350个/μL之间,经统计学检验均有统计学意义;第2位未治疗原因是＂经济困难,无法支付路费和检测费＂（19.7%）,该原因主要出现在广西和云南调查点,河南调查点没有病例选择该原因。结论主观原因成为影响病人未进行抗病毒治疗的主要原因,尤其是未出现明显临床症状的病人,医务工作者需继续加强对病人抗病毒治疗知识的宣传,帮助病人利用科学指标做出正确的判定,而不是仅仅依靠病人的主观判定。

Why 395 HIV/AIDS patients failed to receive HAART

Objective To explore the reasons why human immunodeficiency virus（HIV） and acquired immunodeficiency syndrome（AIDS）（HIV/AIDS） patients failed to receive highly active antiretroviral therapy（HAART）.Methods Three hundred and ninety five HIV/AIDS cases from three survey sites of Guangxi,Henan and Yunnan were selected.Cross-sectional survey was conducted,and questionnaires were administered to clarify the reasons for not receiving HAART.The information collected was classified for statistical analysis.Results The eight major reasons chosen by the subjects individually for not receiving HAART were divided into 2 categories： subjective reasons and objective reasons.The subjective reasons comprised the majority（62.5%）,ranking the top six.As shown by the survey in the 3 sites,the first reason ＂self-perceived good health＂（48.1%）,ranked the top.The majority of the respondents（61.1%） who selected the first reason were free of any AIDS related clinical symptoms and their CD4 test results was between 200-350copies/μL,with statistical significance.The second reason for not receiving the treatment was ＂being unaffordable to pay the transportation and testing fees＂（19.7%）.This reason was chosen by some patients in Guangxi and Yunnan survey sites,but no patients in Henan chose it.Conclusion Subjective reasons represent the major arguments for patients failing to receive HAART in time,especially for those without obvious clinical symptoms.Medical workers need to publicize knowledge of anti-viral treatment to encourage patients to make correct judgment by utilizing scientific indicators,rather than relying solely on their subjective perceptions.