Adherence and Risk Behaviour in Patients with HIV Infection Receiving Antiretroviral Therapy in Bangkok.

The Open Virology Journal Pub Date : 2012-01-01 Epub Date: 2012-02-24 DOI:10.2174/1874357901206010023
Amanda Clarke, Stephen Kerr, Adam Honeybrook, David A Cooper, Anchalee Avihingsanon, Chris Duncombe, Praphan Phanuphak, Kiat Ruxrungtham, Jintanat Ananworanich, John Kaldor
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引用次数: 10

Abstract

It could be postulated that due to lifestyle factors, patients with poor antiretroviral therapy (ART) adherence may also have risky sexual behaviour potentially leading to HIV transmission. There are limited data regarding unprotected sex risk and ART adherence in resource limited settings and our study set out to investigate these in an HIV clinic in Bangkok. Patients completed an anonymous questionnaire regarding their relationship details, ART adherence, sexual behaviour, alcohol and drug use and HIV transmission beliefs. Laboratory findings and medical history were also collected. Unprotected sex risk (USR) was defined as inconsistent condom use with a partner of negative or unknown HIV status. Five hundred and twelve patients completed the questionnaire. Fifty seven per cent of patients reported having taken ARV >95% of the time in the last month and 58% had been sexually active in the previous 30 days. Only 27 patients (5%) were classified as having USR in our cohort. Multivariate analysis showed USR was associated with female gender (OR 2.9, 95% CI 1.2-7.0, p0.02) but not with adherence, age, type or number of partners, recreational drug or alcohol use nor beliefs about HIV transmission whilst taking ART. Levels of USR in this resource limited setting were reassuringly low and not associated with poor ART adherence; as all USR patients had undetectable viral loads onward HIV transmission risk is likely to be low but not negligible. Nonetheless condom negotiation techniques, particularly in women, may be useful in this group.

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曼谷接受抗逆转录病毒治疗的艾滋病毒感染者的依从性和危险行为
可以假设,由于生活方式因素,抗逆转录病毒治疗依从性差的患者也可能有危险的性行为,可能导致艾滋病毒传播。在资源有限的情况下,关于无保护的性行为风险和抗逆转录病毒治疗依从性的数据有限,我们的研究开始在曼谷的一家艾滋病毒诊所进行调查。患者填写了一份关于其关系细节、抗逆转录病毒治疗依从性、性行为、酒精和药物使用以及艾滋病毒传播信念的匿名问卷。还收集了实验室结果和病史。无保护性行为风险(USR)被定义为与HIV阴性或未知的伴侣不一致使用安全套。512名患者完成了问卷调查。57%的患者报告在上个月服用抗逆转录病毒药物的时间超过95%,58%的患者在过去30天内性活跃。在我们的队列中,只有27例患者(5%)被归类为USR。多变量分析显示USR与女性性别相关(OR为2.9,95% CI为1.2-7.0,p0.02),但与依从性、年龄、伴侣类型或数量、娱乐性药物或酒精的使用以及在接受抗逆转录病毒治疗时对艾滋病毒传播的信念无关。在这种资源有限的情况下,USR水平低得令人放心,与抗逆转录病毒治疗依从性差无关;由于所有USR患者均未检测到病毒载量,因此艾滋病毒传播风险可能很低,但不可忽略。尽管如此,避孕套的谈判技巧,尤其是对女性来说,可能对这一群体有用。
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