影响抗逆转录病毒疗法依从性的患者相关因素——以赞比亚南部奇武纳为例

H. Ntalasha, J. Malungo, Sonja Merten, A. Phiri, S. Simona
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引用次数: 0

摘要

尽管赞比亚许多公共诊所推出了免费的延长艾滋病毒和艾滋病寿命的药物,而且抗逆转录病毒药物在降低艾滋病毒感染者死亡率方面发挥了有据可查的作用,但一些艾滋病毒感染者仍然放弃了治疗。本研究探讨了影响患者对延长生命药物依从性的相关因素。希望这些信息将有助于提高依从性,从而实现抗逆转录病毒疗法的目标。考虑到无可辩驳的证据表明,不依从抗逆转录病毒治疗(ART)会导致耐药性,从而导致耐药HIV的传播,这些信息至关重要。抗药性艾滋病毒不仅处理费用高昂,而且可能导致发病率、死亡率增加,艾滋病毒病例发生率增加,尤其是对赞比亚这样的低收入国家来说。方法:本文使用了在农村环境中进行的大型混合方法研究的数据。这项研究探讨了患者相关因素如何影响艾滋病毒感染者继续服药。因此,本文讨论了接受抗逆转录病毒治疗的HIV感染者报告的能够持续服药或未能服药的主要原因。结果:限制因素和促进因素都被确定为影响依从性的因素。在确定的促进者中,有一位有提醒,在接受抗逆转录病毒疗法后感觉更好,看到接受抗逆转录疫苗疗法的人康复,希望活得更长,并透露自己的积极状态。限制因素包括忘记服药、在治疗一段时间后无法康复以及药物疲劳。研究发现,坚持治疗与有提醒、希望活得更长以及看到接受抗逆转录病毒治疗的人病情好转之间存在显著关联。结论:虽然促进者提高了依从性,但这些障碍阻碍或阻碍了接受抗逆转录病毒疗法的人继续服用医疗保健提供者开具的艾滋病药物。为了避免耐药性和其他公共卫生影响,如耐药性艾滋病毒的传播和死亡,需要解决这些与患者有关的障碍。
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Patient-Related Factors Influencing Adherence to ART, A Case of Chivuna, Southern Province of Zambia
Despite the roll out of free life prolonging HIV and AIDS drugs in many public clinics in Zambia and the well documented effects of Anti Retrovirals (ARVs) in reducing mortality among people living with HIV, some people living with HIV still abandon treatment. This study explores patient-related factors that influence adherence to the life prolonging drugs. It is hoped that such information would be useful in enhancing adherence so as to achieve the goal of ART. This information is critical considering irrefutable evidence that non-adherence to Anti-Retroviral Therapy (ART) can lead to drug resistance and consequently, transmission of drug resistant HIV. Drug resistant HIV is not only expensive to handle, but can lead to increased morbidity, mortality and increased incidence of HIV cases particularly, for a low income country like Zambia. Methods: This paper uses data from a large mixed method study which was conducted in a rural setting. The study explored how patient-related factors influence people living with HIV in continuing taking of medication. The paper, therefore, discusses the major reasons reported by HIV infected people on ART for either being able to consistently take their medication or failing to do so. Results: Both limiting and facilitating factors were identified as influencing adherence. Among the facilitators identified were one having a reminder, feeling better after being on ART, seeing someone on ART recover, desire to live longer and disclosure of one’s positive status. The limiting factors included forgetting to take medication, non-recovery while on treatment for some time and drug fatigue. A significant association was found between adherence treatment and one having a reminder, desire to live longer and seeing someone on ART get better. Conclusion: While facilitators enhanced adherence, the barriers prevented or discouraged people on ART from continuing taking AIDS medicines as prescribed by their health care providers. In order to avoid drug resistance and other public health implications, such as transmission of drug resistant HIV virus and deaths, there is need to address these patient-related barriers.
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