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Same-Day ART Initiation and Associated Factors Among People Living with HIV on Lifelong Therapy at Nekemte Specialized Hospital, Western Ethiopia. 在埃塞俄比亚西部Nekemte专科医院接受终身治疗的艾滋病毒感染者中,当日开始抗逆转录病毒治疗及其相关因素
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S395238
Lami Bayisa, Diriba Bayisa, Ebisa Turi, Diriba Mulisa, Tadesse Tolossa, Adugna Olani Akuma, Merga Chala Bokora, Dawit Tesfaye Rundasa

Background: The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia.

Methods: A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value <0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value <0.05 were used to declare statistical significance.

Results: A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2-68.8]. Urban dwellers (AOR = 3.93 (95% 1.96-7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54-10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71-21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37-3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10-3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0-5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08-5.518)), and with BMI ≥25 kg/m2 (AOR = 2.18 (95% CI: 1.05-4.52)) were significantly associated with same-day ART initiation.

Conclusion: Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.

背景:检测和治疗方法建议尽早开始抗逆转录病毒治疗(同一天)。早期开始抗逆转录病毒治疗具有治疗和预防双重效益。然而,关于埃塞俄比亚当日开始抗逆转录病毒治疗的信息有限。因此,本研究旨在评估埃塞俄比亚西部Nekemte专科医院艾滋病毒感染者(PLHIV)当天开始抗逆转录病毒治疗的程度和因素。方法:于2021年1月10日至2月15日对483例PLHIV患者进行横断面研究。数据是通过调查问卷收集的。使用Epi Data 3.1和STATA 14.0分别进行数据录入和分析。具有p值结果的变量:共有483名研究对象参与,反应率为100%。其中三分之二(65%)的患者在同一天开始ART治疗,95% CI[60.2-68.8]。城市居民(AOR = 3.93(1.96 - -7.87) 95%),没有OIs (AOR = 4.02(95%置信区间:1.54—-10.47)),不进行结核病筛检(AOR = 6.02(95%置信区间:1.71—-21.15)),测试通过VCT (AOR = 2.32(95%置信区间:1.37—-3.26)),没有使用CPT (AOR = 1.88(95%置信区间:1.10—-3.23)),没有使用IPT (AOR = 2.36(95%置信区间:1.0—-5.57)),测试在2019/20 (AOR = 2.37(95%置信区间:1.08—-5.518)),并与BMI≥25 kg / m2 (AOR = 2.18(95%置信区间:1.05—-4.52)明显与当天艺术启蒙。结论:三分之二的研究对象在HIV诊断当天开始抗逆转录病毒治疗。应加强和加强对新诊断的艾滋病毒阳性患者的自愿检测和立即转介艾滋病毒护理、倡导检测和治疗以及密集咨询。鉴于此,应高度重视未进行结核病筛查、未使用CPT和IPT预防的城市居民。
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引用次数: 0
Development of Hypertension and Diabetes Mellitus, and Associated Factors, Among Adult HIV Patients in Ethiopia. 埃塞俄比亚成年艾滋病患者中高血压和糖尿病的发展及其相关因素
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S397511
Yadessa Tegene, Selamawit Mengesha, Erin Putman, Alemayehu Toma, Mark Spigt

Background: Medical improvements and increased access to treatment have turned HIV from a highly fatal disease into a treatable and controllable disease. With the improvement in lifespan, HIV patients face increasing morbidity and mortality from chronic comorbidities (hypertension and diabetes mellitus). There is, nevertheless, a paucity of information on the scale of HIV noncommunicable disease comorbidity and its associated factors. This study aimed to investigate the incidence and predictors of chronic comorbidity in HIV patients in a resource-limited setting.

Methods: A prospective cohort study was conducted from 2019 to 2021. We included 520 HIV patients at baseline. Patients without hypertension or diabetes were followed for two years to determine the incidence of developing comorbidities. Nine trained nurses used a pre-tested structured questionnaire to collect data during routine care consultations in three hospitals in southern Ethiopia. To find predictors of these chronic comorbidities, a multivariable logistic regression analysis was used.

Results: After two years, 54 out of 377 participants, or 14%, had chronic comorbidity, which is defined as having diabetes and/or hypertension. Hypertension (12%) and diabetes (4%), respectively, were observed. When compared to those who were not overweight, the risk of developing chronic comorbidity was three times higher in overweight people [AOR = 3.45, 95% CI: (1.04, 11.45), P = 0.045]. Older participants were about 6 times more likely than younger participants to have chronic comorbidity [AOR = 4.93, 95% CI: (1.56, 15.57), P = 0.007]. Those who did not engage in regular physical activity were twice as likely to develop chronic comorbidity [AOR = 2.16, 95% CI: (1.09, 4.29), P = 0.027].

Conclusion: The incidence of chronic comorbidity was high in the study population. Targeted screening for early signs of chronic comorbidity, nutritional counseling, and awareness creation in regular physical activity programs should be integrated into HIV care to prevent and control chronic comorbidity in resource-limited settings.

背景:医疗进步和治疗机会的增加使艾滋病毒从一种高度致命的疾病转变为一种可治疗和可控的疾病。随着寿命的延长,HIV患者面临慢性合并症(高血压和糖尿病)的发病率和死亡率增加。然而,缺乏关于艾滋病毒非传染性疾病合并症的规模及其相关因素的信息。本研究旨在调查资源有限的HIV患者慢性合并症的发生率和预测因素。方法:2019 - 2021年进行前瞻性队列研究。我们纳入了520名艾滋病患者作为基线。无高血压或糖尿病的患者随访两年,以确定并发疾病的发生率。在埃塞俄比亚南部的三家医院,九名训练有素的护士在常规护理咨询期间使用预先测试的结构化问卷收集数据。为了找到这些慢性合并症的预测因素,我们使用了多变量logistic回归分析。结果:两年后,377名参与者中有54人(14%)患有慢性合并症,即糖尿病和/或高血压。分别观察到高血压(12%)和糖尿病(4%)。与非超重人群相比,超重人群发生慢性合并症的风险是非超重人群的3倍[AOR = 3.45, 95% CI: (1.04, 11.45), P = 0.045]。老年参与者患慢性合并症的可能性约为年轻参与者的6倍[AOR = 4.93, 95% CI: (1.56, 15.57), P = 0.007]。不定期进行体育锻炼的患者发生慢性合并症的可能性是前者的两倍[AOR = 2.16, 95% CI: (1.09, 4.29), P = 0.027]。结论:研究人群中慢性合并症的发生率较高。针对慢性合并症的早期症状进行有针对性的筛查、进行营养咨询以及在常规体育活动项目中提高认识,应纳入艾滋病毒护理,以在资源有限的环境中预防和控制慢性合并症。
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引用次数: 0
Factors Associated with Retention in HIV Care Among HIV-Positive Adolescents in Public Antiretroviral Therapy Clinics in Ibanda District, Rural South Western Uganda. 乌干达西南部农村伊班达区公共抗逆转录病毒治疗诊所中艾滋病毒阳性青少年艾滋病毒护理保留的相关因素
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S401611
Christine Nimwesiga, Ivan Mugisha Taremwa, Damalie Nakanjako, Esther Nasuuna

Background: Retention in antiretroviral therapy (ART) care is a key indicator of Human Immunodeficiency Virus (HIV) treatment success as it improves adherence, critical for better treatment outcomes and prevention of drug resistance. HIV treatment among adolescents living with HIV (ALHIV) is characterized by loss to follow-up, poor ART adherence, and eventual death. This study assessed retention in ART care and the associated factors among ALHIV in Ibanda district, rural South Western Uganda.

Methods: This was a retrospective cohort study using clinical data from ALHIV enrolled from 2019 to 2020 in eight health facilities in Ibanda district. Data from the Electronic Medical Record (EMR) system was extracted to assess the associated factors and participants' status two years after enrollment. Data were analyzed using EPIdata version 3.1 in which Univariate and multivariate cox proportional hazard regression analyses were determined. A hazard ratio (HR) at a 95% confidence interval was obtained, and a P-value <0.05 was considered statistically significant.

Results: Eighty-four ALHIV comprising 86.9% (N = 73) females were enrolled. The majority 63.1% (N = 53) resided in semi/peri-urban, and 44.0% (N = 37) stayed less than 5 km from the facility. Only 35.7% (N = 30) were active on ART, while 17 (20.2%) and 36 (42.9%) were lost to follow-up and transfer-outs, respectively. Factors associated with low retention were: ALHIV that moved 5-10Km (HR = 5.371; 95% CI: 1.227-23.5050, p = 0.026), used differential service delivery model was Facility-Based Group (FBG) (HR = 12.419; 95% CI: 4.034-38.236, p < 0.001) and those enrolled on the Young Adolescent Program Support (YAPs) (HR = 4.868; 95CI:1.851-12.803; p = 0.001). Retention reduced with increasing ART duration, ALHIV on (TDF/3TC/EFV) (p < 0.001), lived more than 10Km (p = 0.043) and did not benefit from any intervention (p < 0.001).

Conclusion: Results showed low retention in care and the urgent need to strengthen individual case management strategies for ALHIV, thus interventions focusing on peer support are desired.

背景:坚持抗逆转录病毒治疗(ART)护理是人类免疫缺陷病毒(HIV)治疗成功的一个关键指标,因为它提高了依从性,对更好的治疗结果和预防耐药性至关重要。感染艾滋病毒的青少年接受艾滋病毒治疗的特点是缺乏随访、抗逆转录病毒治疗依从性差和最终死亡。本研究评估了乌干达西南部农村伊班达地区艾滋病病毒感染者在抗逆转录病毒治疗中的保留情况及其相关因素。方法:这是一项回顾性队列研究,使用了2019年至2020年在伊班达区8个卫生机构登记的ALHIV临床数据。从电子病历(EMR)系统中提取数据,以评估相关因素和参与者在入组两年后的状态。数据分析采用EPIdata 3.1版本,采用单因素和多因素cox比例风险回归分析。结果:共纳入84例ALHIV患者,其中86.9% (N = 73)为女性。63.1% (N = 53)的受访者居住在半城市或近郊,44.0% (N = 37)的受访者居住在距离医疗设施不到5公里的地方。只有35.7% (N = 30)的患者在ART治疗中有活性,17例(20.2%)和36例(42.9%)分别失去随访和转移治疗。与低滞留相关的因素有:ALHIV移动5-10Km (HR = 5.371;95% CI: 1.227-23.5050, p = 0.026),采用的差异服务交付模式为设施基础组(FBG) (HR = 12.419;95% CI: 4.034-38.236, p < 0.001)和参加青少年项目支持(YAPs)的患者(HR = 4.868;95 ci: 1.851 - -12.803;P = 0.001)。滞留率随着抗逆转录病毒治疗时间的增加而降低,ALHIV存活时间(TDF/3TC/EFV) (p < 0.001)超过10Km (p = 0.043),并且没有从任何干预中获益(p < 0.001)。结论:结果显示ALHIV患者的护理保留率低,急需加强个案管理策略,因此需要以同伴支持为重点的干预措施。
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引用次数: 0
Nutritional Treatment Outcomes of Therapeutic Feeding Program and Its Predictors Among HIV Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa City, Sidama, Southern Ethiopia: A Retrospective Cohort Study. 埃塞俄比亚南部希达马阿瓦萨市阿瓦萨大学综合专科医院艾滋病患者治疗性喂养计划的营养治疗结果及其预测因素:一项回顾性队列研究。
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S395936
Helen Tadesse, Alemayehu Toma

Background: HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia.

Methods: Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval.

Results: The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure.

Conclusion: Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.

背景:艾滋病毒引起的营养不良在世界不同地区非常普遍,特别是在撒哈拉以南非洲。食品干预一揽子计划是通过营养评估、咨询和护理来解决艾滋病毒感染者营养不良问题的战略之一。然而,对这些患者在治疗方案中的干预结果知之甚少。因此,本研究旨在评估埃塞俄比亚成年艾滋病毒阳性营养不良个体的营养治疗结果及其预测因素。方法:对阿瓦萨大学综合专科医院成人抗逆转录病毒治疗门诊进行回顾性队列研究。采用结构化问卷法,通过处方登记簿和患者卡片提取419例患者的数据。采用Cox-proportional Hazard模型通过确定风险比和95%置信区间来评估统计学显著性。结果:成人HIV患者经处方治疗入组后营养不良恢复的比例为53.0%。在最终模型中,发现与处方食品营养治疗效果良好相关的变量是女性(调整风险比(AHR) = 3.38, 95% CI: 2.15, 5.32),中等教育(AHR = 2.16, 95% CI: 1.11, 4.18),高等教育(AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20;95% CI: 0.12, 0.35)和HAART (AHR = 2.70, 95% CI: 1.50, 4.86)。基线营养评估时患有严重急性营养不良(SAM) (AHR = 3.42, 95% CI;2.81, 5.15),接受抗逆转录病毒治疗超过12个月(AHR = 0.26, 95% CI: 0.13, 0.84)和检测呈阳性后立即开始HAART治疗(AHR = 0.26, 95% CI: 0.13, 0.84)与营养治疗失败显著相关。结论:经处方治疗后,53%的艾滋病患者营养不良恢复。
{"title":"Nutritional Treatment Outcomes of Therapeutic Feeding Program and Its Predictors Among HIV Patients at Hawassa University Comprehensive Specialized Hospital, Hawassa City, Sidama, Southern Ethiopia: A Retrospective Cohort Study.","authors":"Helen Tadesse,&nbsp;Alemayehu Toma","doi":"10.2147/HIV.S395936","DOIUrl":"https://doi.org/10.2147/HIV.S395936","url":null,"abstract":"<p><strong>Background: </strong>HIV-induced malnutrition is highly prevalent in different parts of the world particularly in sub-Saharan Africa. The food intervention package is one of the strategies that targets malnutrition among HIV-infected people through nutritional evaluation, counseling and care. However, little is known concerning the outcomes of intervention in such patients in treatment program. Therefore, this study aimed to assess nutritional treatment outcomes and its predictors among adult HIV-positive undernourished individuals in Ethiopia.</p><p><strong>Methods: </strong>Facility based retrospective cohort study was deployed in Adult Antiretroviral therapy clinic of Hawassa University Comprehensive Specialized Hospital. Data of 419 patients were extracted from the food by prescription registration book and patient cards using structured questionnaires. Statistical significance was assessed using Cox-proportional Hazard model by determining hazard ratios and 95% confidence interval.</p><p><strong>Results: </strong>The proportion of adult HIV patients who recovered from malnutrition after they were enrolled in the food by prescription therapy was 53.0%. The variables found to have an association with good nutritional treatment outcomes of food by prescription in the final model are being female (Adjusted Hazard Ratio (AHR) = 3.38, 95% CI: 2.15, 5.32), secondary education (AHR = 2.16, 95% CI: 1.11, 4.18), tertiary education (AHR = 3.75, 95% CI: 1.66, 8.48), SAM (AHR = 0.20; 95% CI: 0.12, 0.35), and HAART (AHR = 2.70, 95% CI: 1.50, 4.86). Having Severe Acute Malnutrition (SAM) at baseline nutritional assessment (AHR = 3.42, 95% CI; 2.81, 5.15), taking ART for more than 12 months (AHR = 0.26, 95% CI: 0.13, 0.84) and starting HAART immediately after testing positive (AHR = 0.26, 95% CI: 0.13, 0.84) are significantly associated with nutritional treatment failure.</p><p><strong>Conclusion: </strong>Fifty-three percent of HIV patients recovered from malnutrition after they were enrolled in the food by prescription therapy.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/4c/hiv-15-83.PMC10008424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9119837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Prevalence and Patterns of Adverse Drug Events Among Adult Patients with Human Immune Virus Infection on Dolutegravir-Based Antiretroviral Drug Regimens in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study. 埃塞俄比亚西北部阿姆哈拉综合专科医院以多路替格雷韦为基础的抗逆转录病毒药物治疗方案的成人免疫病毒感染患者药物不良事件的流行和模式:一项多中心回顾性随访研究。
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S411948
Alemu Birara Zemariam, Yabibal Berie Tadesse, Abebe Tarekegn Kassaw

Background: Antiretroviral therapy (ART) refers to any HIV treatment that uses a combination of two or more drugs to suppress viral load and preserve immunofunction. Despite the success of ART, adverse events persist, in particular in patients with baseline viral loads >100,000 copies/mL. Apart from premarketing surveillance, the safety and risk profile of dolutegravir has not been thoroughly researched in Ethiopia. Therefore, this study aimed to assess the prevalence and patterns of adverse drug events among HIV-infected adult patients on dolutegravir-based ART regimens at Amhara comprehensive specialized hospitals, northwest Ethiopia.

Methods: A retrospective follow-up study was conducted from January 1, 2019 to December 31, 2021 at Amhara comprehensive specialized hospitals, with a sample size of 423. Simple random sampling was employed and data collected using kobo tool box software by four trained BSc nurses from March to April, 2022. SPSS 25 was used for analysis. Descriptive summary statistics are used and data presented using tables and text.

Results: A total of 372 patient charts were included in the final analysis, and the prevalence of adverse events associated with dolutegravir was found to be 37.6% (95% CI 32.1%-42.1%). Nearly two-thirds (60.7%) of the participants had neuropsychiatric symptoms, followed by gastrointestinal symptoms (23.6%) and hepatic problems (7.14%). All recorded adverse events were mild.

Conclusion: Dolutegravir adverse events were relatively low compared to previous studies. Common adverse events reported were neuropsychiatric symptoms and gastrointestinal symptoms, followed by hepatic and renal events. All adverse events were mild and none was severe or life-threatening events. Therefore, we recommend the use of dolutegravir in clinical settings.

背景:抗逆转录病毒治疗(ART)是指使用两种或两种以上药物的组合来抑制病毒载量和保持免疫功能的任何HIV治疗。尽管抗逆转录病毒治疗取得了成功,但不良事件持续存在,特别是在基线病毒载量>100,000拷贝/mL的患者中。除了上市前的监测外,在埃塞俄比亚还没有对多鲁特韦的安全性和风险概况进行彻底的研究。因此,本研究旨在评估埃塞俄比亚西北部阿姆哈拉综合专科医院接受以盐酸孕酮为基础的抗逆转录病毒治疗方案的艾滋病毒感染成年患者中药物不良事件的发生率和模式。方法:于2019年1月1日至2021年12月31日在阿姆哈拉综合专科医院进行回顾性随访研究,样本量为423人。于2022年3 - 4月对4名经过培训的BSc护士进行简单随机抽样,使用kobo工具箱软件进行数据采集。采用SPSS 25进行分析。使用描述性汇总统计,并使用表格和文本呈现数据。结果:最终分析共纳入372例患者病历,发现与多替格拉韦相关的不良事件发生率为37.6% (95% CI 32.1% ~ 42.1%)。近三分之二(60.7%)的参与者有神经精神症状,其次是胃肠道症状(23.6%)和肝脏问题(7.14%)。所有记录的不良事件均为轻度。结论:与以往的研究相比,多来替韦的不良事件相对较低。报告的常见不良事件是神经精神症状和胃肠道症状,其次是肝脏和肾脏事件。所有的不良事件都是轻微的,没有严重或危及生命的事件。因此,我们建议在临床环境中使用多替格雷韦。
{"title":"Prevalence and Patterns of Adverse Drug Events Among Adult Patients with Human Immune Virus Infection on Dolutegravir-Based Antiretroviral Drug Regimens in Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A Multicenter Retrospective Follow-Up Study.","authors":"Alemu Birara Zemariam,&nbsp;Yabibal Berie Tadesse,&nbsp;Abebe Tarekegn Kassaw","doi":"10.2147/HIV.S411948","DOIUrl":"https://doi.org/10.2147/HIV.S411948","url":null,"abstract":"<p><strong>Background: </strong>Antiretroviral therapy (ART) refers to any HIV treatment that uses a combination of two or more drugs to suppress viral load and preserve immunofunction. Despite the success of ART, adverse events persist, in particular in patients with baseline viral loads >100,000 copies/mL. Apart from premarketing surveillance, the safety and risk profile of dolutegravir has not been thoroughly researched in Ethiopia. Therefore, this study aimed to assess the prevalence and patterns of adverse drug events among HIV-infected adult patients on dolutegravir-based ART regimens at Amhara comprehensive specialized hospitals, northwest Ethiopia.</p><p><strong>Methods: </strong>A retrospective follow-up study was conducted from January 1, 2019 to December 31, 2021 at Amhara comprehensive specialized hospitals, with a sample size of 423. Simple random sampling was employed and data collected using kobo tool box software by four trained BSc nurses from March to April, 2022. SPSS 25 was used for analysis. Descriptive summary statistics are used and data presented using tables and text.</p><p><strong>Results: </strong>A total of 372 patient charts were included in the final analysis, and the prevalence of adverse events associated with dolutegravir was found to be 37.6% (95% CI 32.1%-42.1%). Nearly two-thirds (60.7%) of the participants had neuropsychiatric symptoms, followed by gastrointestinal symptoms (23.6%) and hepatic problems (7.14%). All recorded adverse events were mild.</p><p><strong>Conclusion: </strong>Dolutegravir adverse events were relatively low compared to previous studies. Common adverse events reported were neuropsychiatric symptoms and gastrointestinal symptoms, followed by hepatic and renal events. All adverse events were mild and none was severe or life-threatening events. Therefore, we recommend the use of dolutegravir in clinical settings.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/a6/hiv-15-271.PMC10241189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors of Viral Load Status Over Time Among HIV Infected Adults Under HAART in Zewditu Memorial Hospital, Ethiopia: A Retrospective Study. 埃塞俄比亚Zewditu纪念医院接受HAART治疗的HIV感染成人中病毒载量随时间变化的预测因素:一项回顾性研究
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S396030
Ayitenew Agegn Gwadu, Mengistu Abebe Tegegne, Kidist Belay Mihretu, Awoke Seyoum Tegegne

Background: HIV attacks the CD4 cells which are responsible for the body's immune response to infectious agents. The main objective of this study was to identify predictors of viral load status over time among HIV patients under HAART in Zewditu Memorial Hospital.

Methods: A retrospective institutional-based cohort study design was conducted on 161 HIV-infected adults under HAART whose follow-ups were from January 2014 up to December 2017. A generalized linear mixed-effects model was conducted to infer predictors of the status of viral load at 95% of CI).

Results: The descriptive statistics revealed that about 55.9% of the adults under treatment had a detected viral load status. Among the potential predictors, visiting time of patients (AOR = 0.731, 95%: (0.634,0.842) and p-value <0.01), age of patients (AOR = 1.0666, 95% CI: (1.0527,1.0917) and p-value <0.01), weight (AOR=. 0.904, 95% CI: (0.862, 0.946) and p-value <0.01), baseline CD4 cell count (AOR = 0.996, 95% CI: (0.994, 0.998) and P-value <0.01), educated patients (AOR = 0.030, 95% CI: (0.002, 0.385) and p-value=0.0053), rural patients (AOR = 6.30,95% CL: (1.78, 2.25) and p-value=0.0043), working status patients (AOR = 0.5905, 95% CI: (0.547,0.638), p-value <0.01), poor adherent patients (AOR = 1.120, 95% CI; (1.035,1.391) and p-value = 0.016) and patients disclosed the disease status (AOR = 0.195, 95% CI: (0.023, 0.818) and p-value=0.0134) significantly affected the detection status of viral loads, keeping all other covariates constant.

Conclusion: The predictor variables; visiting times, the weight of patients, residence area, age of patients, educational level, clinical stages, functional status, baseline CD4 cell count, adherence status, and disclosure status of the disease statistically and significantly affected the status of viral load. Hence, health-related education should be given for patients to disclose their disease status, to be good adherents based on the prescription given to the health staff. Due attentions should be given for rural and uneducated patients. Attention should be forwarded to for non-adherent patients to follow the instruction given by the health staff.

背景:HIV攻击负责机体对感染因子免疫反应的CD4细胞。本研究的主要目的是确定Zewditu纪念医院接受HAART治疗的HIV患者病毒载量随时间变化的预测因素。方法:采用基于机构的回顾性队列研究设计,对2014年1月至2017年12月接受HAART治疗的161名成年hiv感染者进行随访。采用广义线性混合效应模型来推断病毒载量状态的预测因子(95% CI)。结果:描述性统计显示,接受治疗的成年人中约有55.9%检测到病毒载量状态。潜在预测因素中,患者就诊时间(AOR = 0.731, 95%:(0.634,0.842)和p值。就诊次数、患者体重、居住区域、患者年龄、文化程度、临床分期、功能状态、基线CD4细胞计数、依从性状态、疾病披露状态对病毒载量状态的影响具有统计学意义和显著性。因此,应对患者进行健康相关教育,使其了解自己的病情,并根据医护人员开出的处方,成为良好的依从者。对农村和文化程度低的病人应给予应有的重视。对于非依从性患者,应注意遵循卫生工作人员给出的指示。
{"title":"Predictors of Viral Load Status Over Time Among HIV Infected Adults Under HAART in Zewditu Memorial Hospital, Ethiopia: A Retrospective Study.","authors":"Ayitenew Agegn Gwadu,&nbsp;Mengistu Abebe Tegegne,&nbsp;Kidist Belay Mihretu,&nbsp;Awoke Seyoum Tegegne","doi":"10.2147/HIV.S396030","DOIUrl":"https://doi.org/10.2147/HIV.S396030","url":null,"abstract":"<p><strong>Background: </strong>HIV attacks the CD4 cells which are responsible for the body's immune response to infectious agents. The main objective of this study was to identify predictors of viral load status over time among HIV patients under HAART in Zewditu Memorial Hospital.</p><p><strong>Methods: </strong>A retrospective institutional-based cohort study design was conducted on 161 HIV-infected adults under HAART whose follow-ups were from January 2014 up to December 2017. A generalized linear mixed-effects model was conducted to infer predictors of the status of viral load at 95% of CI).</p><p><strong>Results: </strong>The descriptive statistics revealed that about 55.9% of the adults under treatment had a detected viral load status. Among the potential predictors, visiting time of patients (AOR = 0.731, 95%: (0.634,0.842) and p-value <0.01), age of patients (AOR = 1.0666, 95% CI: (1.0527,1.0917) and p-value <0.01), weight (AOR=. 0.904, 95% CI: (0.862, 0.946) and p-value <0.01), baseline CD4 cell count (AOR = 0.996, 95% CI: (0.994, 0.998) and P-value <0.01), educated patients (AOR = 0.030, 95% CI: (0.002, 0.385) and p-value=0.0053), rural patients (AOR = 6.30,95% CL: (1.78, 2.25) and p-value=0.0043), working status patients (AOR = 0.5905, 95% CI: (0.547,0.638), p-value <0.01), poor adherent patients (AOR = 1.120, 95% CI; (1.035,1.391) and p-value = 0.016) and patients disclosed the disease status (AOR = 0.195, 95% CI: (0.023, 0.818) and p-value=0.0134) significantly affected the detection status of viral loads, keeping all other covariates constant.</p><p><strong>Conclusion: </strong>The predictor variables; visiting times, the weight of patients, residence area, age of patients, educational level, clinical stages, functional status, baseline CD4 cell count, adherence status, and disclosure status of the disease statistically and significantly affected the status of viral load. Hence, health-related education should be given for patients to disclose their disease status, to be good adherents based on the prescription given to the health staff. Due attentions should be given for rural and uneducated patients. Attention should be forwarded to for non-adherent patients to follow the instruction given by the health staff.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/13/hiv-15-29.PMC9921434.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10715992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Time to Viral Load Suppression and Its Predictors Among Adult Patients on Antiretro Viral Therapy in Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Hossana, Southern Ethiopia. 埃塞俄比亚南部胡萨纳Nigist Eleni Mohammed纪念综合专科医院接受抗逆转录病毒治疗的成年患者病毒载量抑制时间及其预测因素
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S408565
Eshetu Erjino, Ermias Abera, Lire Lemma Tirore

Background: Unsuppressed viral load count in patients on anti-retroviral therapy is linked to poorer survival and increased transmission of the virus. Despite efforts made in Ethiopia, the viral load suppression rate is still low.

Objective: To estimate time to viral load suppression and predictors of viral load suppression among adults on anti-retroviral therapy in Nigist Elen Mohamed Memorial Comprehensive Specialized Hospital, 2022.

Materials and methods: A retrospective follow-up study was conducted among 297 adults on anti-retroviral therapy from January 1, 2016, to December 31, 2021. A simple random sampling technique was used to select study participants. The data were analyzed using STATA 14. Cox regression model was used. The adjusted hazard ratio with 95% CI was estimated.

Results: A total of 296 records of patients on anti-retroviral therapy were included in this study. The incidence of viral load suppression was 9.68 per 100-person months. The median time for viral load suppression was 9 months. Patients with baseline CD4 ≥200 cell/mm3 (AHR: 1.87; 95% CI = 1.34, 2.63), who had no opportunistic infections (AHR = 1.84; 95% CI = 1.34, 2.52), who were on WHO clinical stage-I or II (AHR = 2.12; 95% CI = 1.18, 3.79) and who have taken tuberculosis preventive therapy (AHR = 2.24; 95% CI = 1.66, 3.02) had higher hazards of viral load suppression.

Conclusion: The median time for viral load suppression was 9 months. Patients who had no opportunistic infection, with higher CD4 count, on WHO clinical stage-I or II, who have taken tuberculosis preventive therapy had higher hazards of viral load suppression. Careful monitoring and counseling of patients with CD4 levels lower than 200 cells/mm3 are necessary. Careful monitoring and counseling of patients in advanced WHO clinical stages, with lower CD4 count levels and with opportunistic infections is crucial. Strengthening the provision of tuberculosis preventive therapy is warranted.

背景:在接受抗逆转录病毒治疗的患者中,未抑制的病毒载量计数与较差的生存和病毒传播增加有关。尽管埃塞俄比亚作出了努力,但病毒载量抑制率仍然很低。目的:估计2022年尼日利亚伊伦穆罕默德纪念综合专科医院接受抗逆转录病毒治疗的成人病毒载量抑制时间和病毒载量抑制的预测因素。材料和方法:对2016年1月1日至2021年12月31日接受抗逆转录病毒治疗的297名成年人进行回顾性随访研究。采用简单的随机抽样技术来选择研究参与者。使用STATA 14对数据进行分析。采用Cox回归模型。估计校正后的95% CI的风险比。结果:本研究共纳入296例接受抗逆转录病毒治疗的患者。病毒载量抑制的发生率为9.68 / 100人月。病毒载量抑制的中位时间为9个月。基线CD4≥200 cells /mm3的患者(AHR: 1.87;95% CI = 1.34, 2.63),无机会性感染(AHR = 1.84;95% CI = 1.34, 2.52),处于who临床i期或II期(AHR = 2.12;95% CI = 1.18, 3.79),并接受过结核病预防治疗(AHR = 2.24;95% CI = 1.66, 3.02)有较高的病毒载量抑制风险。结论:病毒载量抑制的中位时间为9个月。没有机会性感染、CD4计数较高、处于世卫组织临床i期或II期、接受过结核病预防治疗的患者病毒载量抑制的危险较高。对CD4水平低于200细胞/mm3的患者进行仔细监测和咨询是必要的。对处于世卫组织晚期临床阶段、CD4计数水平较低和机会性感染的患者进行仔细监测和咨询至关重要。加强提供结核病预防治疗是必要的。
{"title":"Time to Viral Load Suppression and Its Predictors Among Adult Patients on Antiretro Viral Therapy in Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Hossana, Southern Ethiopia.","authors":"Eshetu Erjino,&nbsp;Ermias Abera,&nbsp;Lire Lemma Tirore","doi":"10.2147/HIV.S408565","DOIUrl":"https://doi.org/10.2147/HIV.S408565","url":null,"abstract":"<p><strong>Background: </strong>Unsuppressed viral load count in patients on anti-retroviral therapy is linked to poorer survival and increased transmission of the virus. Despite efforts made in Ethiopia, the viral load suppression rate is still low.</p><p><strong>Objective: </strong>To estimate time to viral load suppression and predictors of viral load suppression among adults on anti-retroviral therapy in Nigist Elen Mohamed Memorial Comprehensive Specialized Hospital, 2022.</p><p><strong>Materials and methods: </strong>A retrospective follow-up study was conducted among 297 adults on anti-retroviral therapy from January 1, 2016, to December 31, 2021. A simple random sampling technique was used to select study participants. The data were analyzed using STATA 14. Cox regression model was used. The adjusted hazard ratio with 95% CI was estimated.</p><p><strong>Results: </strong>A total of 296 records of patients on anti-retroviral therapy were included in this study. The incidence of viral load suppression was 9.68 per 100-person months. The median time for viral load suppression was 9 months. Patients with baseline CD4 ≥200 cell/mm<sup>3</sup> (AHR: 1.87; 95% CI = 1.34, 2.63), who had no opportunistic infections (AHR = 1.84; 95% CI = 1.34, 2.52), who were on WHO clinical stage-I or II (AHR = 2.12; 95% CI = 1.18, 3.79) and who have taken tuberculosis preventive therapy (AHR = 2.24; 95% CI = 1.66, 3.02) had higher hazards of viral load suppression.</p><p><strong>Conclusion: </strong>The median time for viral load suppression was 9 months. Patients who had no opportunistic infection, with higher CD4 count, on WHO clinical stage-I or II, who have taken tuberculosis preventive therapy had higher hazards of viral load suppression. Careful monitoring and counseling of patients with CD4 levels lower than 200 cells/mm3 are necessary. Careful monitoring and counseling of patients in advanced WHO clinical stages, with lower CD4 count levels and with opportunistic infections is crucial. Strengthening the provision of tuberculosis preventive therapy is warranted.</p>","PeriodicalId":46555,"journal":{"name":"HIV AIDS-Research and Palliative Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/2c/hiv-15-157.PMC10124622.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9711185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors Influencing the Status of Adherence to Second Clinic Visit Among Clients Newly Diagnosed with HIV in Northern Uganda: A Mixed-Methods Study. 乌干达北部新诊断为艾滋病毒的患者坚持第二次就诊的影响因素:一项混合方法研究
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S405492
Mary Gorreth Nakate, Bernard Omech, Catherine Kwagala, Irene Gimbo, Augustine Bulitya, Julius Kyeswa, Enoch Katwere, Amir Kabunga, Samson Udho

Background: The "test-and-treat" policy may adversely affect adherence to clinic visits of clients newly diagnosed with HIV due to unpreparedness to commence treatment. However, few studies have examined the factors influencing the status of adherence to second clinic visit among clients newly diagnosed with HIV. We examined the factors influencing the status of adherence to second clinic visit among clients newly diagnosed with HIV in Apac District, northern Uganda.

Methods: This was a mixed-methods study conducted among 292 systematically sampled clients newly diagnosed with HIV for the survey and 15 purposively sampled clients for the in-depth interview from July to August 2020. Quantitative data were collected using a structured questionnaire, while qualitative data were collected using an interview guide. Quantitative data were analyzed descriptively while qualitative data were analyzed thematically.

Results: The mean age of the study participants were 39.5±11 years and their age ranged from 18 to 72 years. Close to three-quarters of study participants adhered to their second clinic visit 74% (214/292). Factors that influenced participants' adherence to the second clinic visit were the adequate HIV pre/post-test counseling positive attitude of clients towards HIV-positive diagnosis, family support, and long waiting time.

Conclusion: More than two-thirds of clients newly diagnosed with HIV in Apac District, northern Uganda adhered to their second clinic visit. HIV/AIDS service providers should strengthen HIV pre/post-test counselling, social support systems for persons living with HIV/AIDS, and reduce clients' waiting time to improve adherence to second clinic visit among clients newly diagnosed with HIV.

背景:“检测和治疗”政策可能会对新诊断为艾滋病毒的客户的依从性产生不利影响,因为他们没有准备好开始治疗。然而,很少有研究调查了影响新诊断为艾滋病毒的客户坚持第二次就诊状况的因素。我们检查了乌干达北部Apac地区新诊断为艾滋病毒的客户对第二次诊所就诊的依从性的影响因素。方法:本研究采用混合方法,于2020年7月至8月对292名新诊断为HIV的客户进行系统抽样调查,并对15名有目的的客户进行深度访谈。定量数据采用结构化问卷收集,定性数据采用访谈指南收集。定量数据采用描述性分析,定性数据采用主题分析。结果:研究对象平均年龄39.5±11岁,年龄18 ~ 72岁。接近四分之三的研究参与者坚持他们的第二次诊所访问74%(214/292)。影响被试第二次访视依从性的因素有充分的HIV前/后咨询、被试对HIV阳性诊断的积极态度、家庭支持和较长的等待时间。结论:在乌干达北部Apac地区,超过三分之二的新诊断为艾滋病毒的客户坚持第二次就诊。艾滋病毒/艾滋病服务提供者应加强艾滋病毒检测前/后咨询,为艾滋病毒/艾滋病感染者提供社会支持系统,并减少客户的等待时间,以提高新诊断为艾滋病毒的客户对第二次诊所就诊的依从性。
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引用次数: 0
Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough? 老年艾滋病毒感染者的治疗方案和护理模式:我们做得够吗?
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S311613
Emily Frey, Carrie D Johnston, Eugenia L Siegler

With improved access to antiretroviral therapy throughout the world, people are aging with HIV, and a large portion of the global population of people with HIV (PWH) is now age 50 or older. Older PWH experience more comorbidities, aging-related syndromes, mental health challenges, and difficulties accessing fundamental needs than the population of older adults without HIV. As a result, ensuring that older PWH are receiving comprehensive healthcare can often be overwhelming for both PWH and the providers. Although there is a growing literature addressing the needs of this population, gaps remain in care delivery and research. In this paper, we suggest seven key components to any healthcare program designed to address the needs of older people with HIV: management of HIV, comorbidity screening and treatment, primary care coordination and planning, attention to aging related-syndromes, optimization of functional status, support of behavioral health, and improved access to basic needs and services. We review many of the difficulties and controversies related to the implementation of these components, which include the absence of screening guidelines for this population and the challenges of care integration, and we suggest key next steps.

随着世界各地抗逆转录病毒治疗可及性的提高,艾滋病毒感染者正在老龄化,全球艾滋病毒感染者(PWH)的很大一部分现在年龄在50岁或以上。与未感染艾滋病毒的老年人相比,老年PWH患者有更多的合并症、衰老相关综合征、精神健康挑战和难以获得基本需求。因此,确保老年PWH获得全面的医疗保健对PWH和提供者来说往往是压倒性的。尽管有越来越多的文献解决了这一人群的需求,但在护理服务和研究方面仍然存在差距。在本文中,我们建议任何旨在满足老年艾滋病毒感染者需求的医疗保健计划的七个关键组成部分:艾滋病毒管理,合并症筛查和治疗,初级保健协调和规划,关注衰老相关综合征,优化功能状态,支持行为健康,改善基本需求和服务的可及性。我们回顾了与这些组成部分的实施相关的许多困难和争议,其中包括缺乏针对这一人群的筛查指南和护理整合的挑战,并提出了关键的下一步措施。
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引用次数: 3
Socioeconomic Inequality in Knowledge About HIV and Its Contributing Factors Among Women of Reproductive Age in Sub-Saharan Africa: A Multicountry and Decomposition Analysis. 撒哈拉以南非洲育龄妇女艾滋病毒知识及其影响因素的社会经济不平等:多国和分解分析
IF 1.5 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.2147/HIV.S392548
Achamyeleh Birhanu Teshale, Getayeneh Antehunegn Tesema

Aim: To examine the socioeconomic inequality in knowledge about HIV and its contributing factors among women of reproductive age in sub-Saharan Africa.

Methods: We have used the most recent demographic and health survey data of the 15 sub-Saharan African countries. 204,495 women of reproductive age made up the entire weighted sample. Erreygers normalized concentration index (ECI) was utilized to evaluate socioeconomic inequality in knowledge about HIV. The variables that contributed to the observed socioeconomic inequality were determined using decomposition analysis.

Results: We found the pro-rich inequality in knowledge about HIV (the weighted ECI was 0.16 with a Standard error = 0.007 and P value< 0.001). The decomposition analysis indicated that educational status (46.10%), wealth status (30.85%), listening to the radio (21.73%), and reading newspapers (7.05%) were among the contributors to the pro-rich socioeconomic inequalities in knowledge about HIV.

Conclusion: Having knowledge about HIV is concentrated among rich reproductive-age women. Educational status, wealth status, and media exposure were the major contributors and should be a priority for interventions to reduce the inequality in knowledge about HIV.

目的:研究撒哈拉以南非洲育龄妇女在艾滋病知识及其影响因素方面的社会经济不平等。方法:我们使用了撒哈拉以南15个非洲国家最新的人口和健康调查数据。204,495名育龄妇女构成了整个加权样本。利用Erreygers归一化浓度指数(ECI)评价HIV知识的社会经济不平等。使用分解分析确定了导致观察到的社会经济不平等的变量。结果:富与富之间存在HIV知识不平等(加权ECI为0.16,标准误差为0.007,P值< 0.001)。分解分析表明,教育程度(46.10%)、财富状况(30.85%)、收听广播(21.73%)和阅读报纸(7.05%)是导致富人在艾滋病知识方面存在社会经济不平等的因素。结论:艾滋病知识的掌握主要集中在富裕的育龄妇女中。教育状况、财富状况和媒体曝光是主要因素,应作为干预措施的优先事项,以减少艾滋病毒知识的不平等。
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引用次数: 1
期刊
HIV AIDS-Research and Palliative Care
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