吸毒感染艾滋病患者高效抗逆转录病毒治疗依从性及相关因素研究

目的 探讨吸毒感染艾滋病患者高效抗逆转录病毒治疗(HAART)依从性及相关因素.方法 在2007年7～9月抽取湖南省衡阳、岳阳、郴州3个地区HAART治疗点,对接受国家免费HAART疗法的111名吸毒感染艾滋病患者进行调查,采用美国社区艾滋病临床研究抗逆转录病毒用药自陈式问卷(CPCRA),来评估抗病毒治疗服药依从性,并分别用抑郁自评量表、家庭关怀度指数问卷来评估患者抑郁症状和家庭功能状况.结果 本组患者服药平均依从水平为83%,有30人(28.8%)服药量在90%或以下,达不到服药量的要求,属于服药依从性差.抑郁标准评分为(60.81±13.03)分,有抑郁症状者占83.9%,而家庭功能良好者仅占30.6%.非条件Logistic回归分析显示抑郁程度(β=-0.48,P=0.024)和治疗时间(β=-1.11,P=0.036)对服药依从率有负性影响,而家庭功能(β=0.65,P=0.043)、脱毒时间(β=0.55,P=0.040)对服药依从率有正性的影响.结论 吸毒感染艾滋病患者HAART治疗依从水平偏低,应通过综合干预如治疗抑郁、帮助脱毒、提高家庭功能、定期评价依从性等来提高患者的服药依从性.

Adherence to highly active antiretroviral treatment and related factors in drug users with HIV/AIDS

Objective To explore adherence to highly active antiretroviral treatment(HAART)and related factors in dnlg users with HIV/AIDS.Methods From July to September 2007,111 HIV-infected drug users who received national free HAART were investigated in the HAART clinics in Hengyang,Yueyang,and Chenzhou districts of Hunan Province.A questionnaire of Community Programs for Clinical Research on AIDS(CPCRA)Antiretroviral Medication Self-Report Was used to assess adherence to HAART,and Zung Depression Scale and Adaptation Partnership Growth Affection Resolve Scale were used to assess patients'depression and family function respectively.ResllIts The average level of adherence to HAART was 83%.Among 111 patients.28.8%of patients reported poor adherence and took medication less than 90%.The mean score of depression was 60.8 1±13.03.There were 83.9%patients demonstrating depressive symptom and only 30.6%patients' family had good function.Logistic regression analysis showed that the degree of depression(β=-0.48,P=0.024)and treatment time(β=-1.11,P=0.036)were significantly associated with adherence negatively,while family function (β=0.65,P=0.043)and the time of being free from drug(β=0.55,P=0.040)were positively associated with adherence.Conclusion The level of adherence to HAART is low in the drug users with HIV/AIDS.Comprehensive interventions are needed to improve adherence to HAART,including managing depression,encouraging drug rehabilitation,improving family function,and evaluating adherence periodically.