上海市静安区HIV感染者管理模式与抗病毒治疗依从性分析

Management mode of HIV infection and antiviral therapy adherence in Jing'an District,Shanghai

【目的】了解上海市静安区HIV感染者抗病毒治疗的依从性现状及相关因素,分析管理模式对治疗依从性的影响。【方法】将2015—2016年"小组关怀管理模式"组的感染者(150例)和未参加管理模式的对照组感染者(150例)中已接受抗病毒治疗者(共221例)作为研究对象,分别收集其一般情况、生活行为方式、抗病毒治疗依从性、生活质量、社会支持、心理状况和医学应对等信息,采用线性回归分析治疗依从性的相关因素。【结果】纳入研究的221例HIV感染者中,模式组124例,对照组97例。治疗依从性良好的比例为86. 0%,模式组和对照组分别为91. 9%和78. 4%。多因素分析显示,治疗依从性的相关因素为管理模式(β=1. 871,P<0. 001)、每月可支配收入(β=0. 600,P=0. 001)、社会支持利用度(β=0. 174,P=0. 044)和屈服的医学应对态度(β=-0. 153,P=0. 003)。【结论】静安区HIV感染者抗病毒治疗依从性有待进一步提高。"小组关怀管理模式"能有效促进感染者治疗依从性的提高,但这一管理模式应从覆盖人数和内容方式两方面进一步改进和完善。

[Objective] To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing′an District,Shanghai.[Methods] We recruited 150 HIV infected patients who participated in the“peer group care”activities(target group)and those from another 150 patients who did not(control group)but received antiviral treatment during the period from 2015 to 2016(221 cases in total)into the study.We collected data on general conditions,behavioral way,antiretroviral therapy adherence,life quality,social support,mental status and medical coping modes,and analyzed the related factors of antiretroviral therapy adherence by linear regression model.[Results] The 221 HIV infected patients were included,with 124 in target group and 97 in control group.The proportion of good antiretroviral therapy adherence was 86.0%,with 91.9% in target group and 78.4% in control group.Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode(β=1.871,P<0.001),disposable income per month(β=0.600,P=0.001),social support utilization(β=0.174,P=0.044)and yield attitude of medical coping modes(β=-0.153,P=0.003).[Conclusion] Antiretroviral therapy adherence of HIV infected patients in Jing′an District should be further improved.“Peer group level care and management mode”could effectively promote the increase of antiretroviral therapy adherence;however,it should be improved and perfected in the aspects of its coverage and content.