HIV单阳家庭接受ART的影响因素及对配偶的影响

Influencing factors of acceptance of antiretroviral therapy and its effect to HIV sero-discordant couples

目的了解人口学因素对艾滋病病毒(HIV)单阳家庭接受抗反转录病毒治疗(ART)意愿的影响,并探究长期ART对HIV单阳家庭夫妻双方关系、安全性行为的影响。方法使用修订的问卷,采用上门访谈的方式,3次随访(基线、3个月、6个月)湖南省邵阳和郴州两市146对HIV单阳家庭。通过拟合Logistic非条件方程,探讨人口学因素对感染者接受ART的综合影响;观察ART过程中受试对象夫妻关系和安全性行为变化。结果 HIV单阳家庭感染者接受ART影响因素可归纳为3个,依次为:健康关注、经济原因和其他;基线、3和6个月随访结果比较,选择夫妻关系中"沟通更顺畅"、安全性行为中"艾滋病知识增加"、"月性行为频次减少"、"增加安全套使用"的家庭数,随ART治疗时间延长而显著增加(P<0.05)。结论HIV单阳家庭ART对象对自身健康关注和家庭经济情况直接影响其治疗意愿,长期干预治疗有助于改善单阳家庭夫妻关系,增强夫妻间性行为的安全意识。

Objective To understand the demographic factors influencing ART acceptance among HIV sero-discordant couples,and explore the effect of long-term ART to HIV sero-discordant couples＇ relationship and safe sex.Methods The information of 146 HIV sero-discordant couples were collected through the questionnaire surveys,and interviews of three visits（baseline,three months later,and six months later）in Shaoyang and Chenzhou.Binary logistic method was used for the analysis.Results Three main factors were found influencing ART acceptance of HIV sero-discordant couples：health care,economic reasons,and others.The results of the three time visits showed that as ART lasted longer,the numbers of couples were increasing by thinking they ＂ communicated more smoothly,＂ ＂increased AIDS-related knowledge,＂ ＂decreased the frequency of sex acts per month＂,and ＂increased use of condoms.＂ Conclusion The health concerns and economic reasons are the main factors influencing acceptance of ART to HIV sero-discordant couples.Long-term ART treatment will help to improve marital relationship of HIV sero-discordant couples,and increase the awareness of safe sex.