云南省某地艾滋病抗病毒治疗脱失患者的调查

An investigation on the Dropout of Patients with HIV/AIDS Receiving Antiviral Therapy in an Area of Yunnan Province

目的调查云南省某地某地接受免费艾滋病抗病毒治疗患者脱失原因及其影响因素.方法整理云南省某地2004年7月至2015年5月的艾滋病抗病毒治疗患者资料,采用χ2检验,Logistic回归分析患者治疗过程中出现脱失的可能影响因素.结果 6 614例接受抗病毒治疗的艾滋病患者中,540例患者由于各种原因在抗病毒治疗过程中脱失,脱失率8.2%.艾滋病抗病毒治疗过程中脱失的主要类型为失访(402例,74.4%),停药(138例,25.6%).婚姻状况为已婚或同居、通过静脉吸毒感染、入组治疗基线CD4细胞计数>500个/μL、接受治疗时间小于6个月等均增加患者治疗过程中脱失概率.结论在艾滋病抗病毒治疗过程中应加强对吸毒人群、未婚/离异、CD4细胞计数>500个/μL和治疗时间在6月内人群应给予重视,加强患者依从性教育和关怀,减少脱失.

Objective To investigate the cause of dropout among people living with HIV/AIDS receiving free antiretroviral therapy（ART） in Yunnan province and its associated factors. Me thods Data of patients with HIV/AIDS receiving ART were collected from ART initiative in July 2004 to May 2015 in four counties of Yunnan Province. The possible factors influencing the patients＇ dropout during the treatment were analyzed by χ2 test and logistic regression analysis. Re s ults Among 6614 patients with HIV/AIDS receiving antiretroviral therapy older than 15 years old,540 patients dropped out of ART for various reasons,accounting for 8.2%. Among 540 patients who dropped out from ART, 74.4% were lost to follow-up and 25.6% quitted ART but could be reached by health workers. The main factors of dropout during the ART included the baseline CD4 count above 500, being non-marital,intravenous drug using,and receiving treatment for less than 6 months. Conclus ion We should pay attention to patients addicted to drug, receiving treatment less than 6 months, being non-marital or divorced and with baseline CD4 count above 500 in order to reduce the dropout rate by strengthening compliance and giving more care.