凉山州成人艾滋病病人服用复方新诺明的现况及影响因素调查

Investigation of current status and the relevant influencing factors of cotrimoxazole prophylaxis in AIDS adult patients in Liangshan,Sichuan province

目的了解凉山州艾滋病（AIDS）病人服用复方新诺明预防艾滋病相关机会性感染的现况,探讨其影响因素及解决路径。方法在凉山州抽取3个县区,采用自行设计的问卷对AIDS病人进行调查,内容包括：人口学特征、复方新诺明使用情况、相关认知及医疗服务现况等,用非条件Logistic回归分析影响因素。结果共调查413名病人,年龄中位数为37岁（IQR：32-42岁）,以男性（69.98%）、彝族（86.68%）、农民（86.20%）为主。有21.55%（89/413）的调查对象报告服用过复方新诺明;医生推荐[比值比（OR）=578.2,95%可信区间（CI）：121.6-5841.8]、上过学（OR=6.9,95%CI：1.9-25.2）、病人感知到用药的益处（OR=4.0,95%CI：1.3-12.0）是促进复方新诺明使用的主要因素。结论凉山州复方新诺明预防机会性感染的使用率较低,应鼓励医生向病人推荐使用复方新诺明的益处和用药知识,进一步提高病人对复方新诺明益处的认识,以便更好地使用复方新诺明预防艾滋病相关机会性感染的发生率,有效降低病人病死率。

Objective To study the current status and influencing factors of cotrimoxazole prophylaxis on AIDS- related opportunistic infections and seek solutions to the problems among adult AIDS patients in Liangshan Yi Autonomous Prefecture, Sichuan Province. Methods AIDS patients in 3 counties of Liangshan Prefecture were enrolled and investigated according to self-designed questionnaires. The contents of the questionnaire included demographic characteristics, cotrimoxazole taking, relevant awareness of cotrimoxazole prophylaxis, AIDS knowledge and accessibility to ART center. Non-conditional Logistic Regression was applied to study the influencing factors. Results Four hundred and thirteen AIDS patients were investigated and the median age was 37 years old [interquartile range （IRQ）： 32-42]. Male patients accounted for 69.98%, Yi nationality 86.68% and farmer 86.20%. Eighty-nine out of 413 patients （21.55 %） reported having taken cotrimoxazole. Doctors＇ recommendation （OR= 578.2, 95%CI： 121.6-5841.8）, being educated （OR=6.9, 95%CI： 1.9-25.2） and self-awareness of benefits of cotrimoxazole prophylaxis （OR=4.0, 95%CI： 1.3-12.0） were main factors promoting cotrimoxazole prophylaxis. Conclusions The proportion of cotrimoxazole prophylaxis among AIDS patients is low. Doctors should be encouraged to recommend cotrimoxazole prophylaxis to the patients, which enables the patients themselves to realize the importance of cotrimoxazole prophylaxis and to take cotrimoxazole, so that mortality as well as the morbidities of AIDS-related opportunistic infections can be reduced.