HIV感染者/AIDS患者高效抗逆转录病毒治疗感知效果影响因素分析

Influencing factors of highly active antiretroviral therapy perceived effect in people living with HIV or AIDS

摘要:

目的： 研究影响HIV感染者/AIDS患者（people living with HIV or AIDS，PLWH）感知高效抗逆转录病毒治疗（highly active antiretroviral therapy，HAART）效果的影响因素，为促进抗病毒治疗提供科学依据。方法： 采用回顾性调查研究方法和面对面问卷调查收集一般人口学信息、艾滋病基本知识、服药情况、服药依从性、HAART疗效自我感知等信息。采用卡方检验、秩和检验、有序分类变量logistic回归进行统计学分析。结果： 共收集到321名调查对象的有效信息，艾滋病基本知识知晓率为88.16%，最近1年有259例患者开展了HIV病毒载量检测，258例病毒载量<50拷贝/mL，最近1次CD4⁺T细胞平均为（444.23±178.29）个/μL。70.09%的PLWH感知到治疗效果为“有效”，6.23%的PLWH感知到治疗效果“非常有效”。出现不良反应后可否自行停药或者减药（OR=0.337，95%CI=0.178~0.638）、治疗前CD4⁺T细胞数量（OR=2.931，95%CI=1.479~5.807）和治疗持续时间（OR=0.438，95%CI=0.230~0.835）这3个变量对感知疗效有影响。结论： HAART治疗效果较好，但与感知效果存在不一致性，家人支持、服药依从性、艾滋病防治知识、治疗前CD4⁺T细胞水平、治疗时间对自我感知疗效有影响，建议采取心理干预、依从性教育等综合干预措施，促进PLWH自我感知效果提高。

Abstract:

Objective: To investigate influencing factors of the perceived effect of highly active antiretroviral therapy (HAART) in people living with HIV or AIDS (PLWH), and to provide scientific basis for the promotion of antiviral therapy. Methods: Retrospective survey was conducted in this study, and face-to-face questionnaire survey was used to collect general demographic information, basic knowledge of AIDS, medication status, medication adherence, and perceived effect of HAART. Chi-square test, rank sum test and ordered categorical variable logistic regression were used as statistical methods. Results: We collected complete information of 321 subjects, and the awareness rate of basic knowledge of AIDS was 88.16%. In the last year, 259 patients had been tested for HIV viral load, 258 of which had a viral load of<50 copies/mL, and the average CD4⁺T cell was (444.23±178.29) /μL for the last time.70.09% of PLWH perceived the therapeutic effect as "effective", and 6.23% of PLWH perceived the therapeutic effect as "very effective". Awareness of stopping or reducing drug taking while adverse reactions occurred (OR=0.337, 95%CI=0.178-0.638), the number of CD4⁺T cells before treatment (OR=2.931, 95%CI=1.479-5.807), duration of treatment (OR=0.438, 95%CI=0.230-0.835) had influence on perceived efficacy. Conclusion: HAART has a good therapeutic effect, but it's inconsistent with the perceived effect. Family support, medication compliance, knowledge of AIDS prevention, CD4⁺T cell level before treatment, and treatment time were associated with self-perceived efficacy. It's suggested to take comprehensive intervention measures such as psychological intervention and compliance education to improve the self-perceived effect of PLWH.