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Highly Active Antiretroviral Therapy Adherence and Psychosocial Status of HIV/AIDS Patients and Their Family Members in China.

机译：中国艾滋病毒/艾滋病患者及其家属的高效抗逆转录病毒疗法依从性和社会心理状况。

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摘要

Background: China's free ART program began from a pilot of 100 HIV/AIDS patients in 2002, and expanded rapidly during the past eight years. By the end of 2010, more than 100,000 HIV/AIDS patients had been treated through this program. Under this potent medical intervention, significant reductions in mortality have been observed among treated patients. The current treatment evaluation system heavily relies on medical indicators, and little is known about the dynamic needs of HIV/AIDS patients and their family members, including supporting factors of treatment adherence in the era of HAART. The primary objective of this study is to understand and evaluate the medical and psychological needs of both treated HIV/AIDS patients and their family members, and to explore the supporting factors of treatment adherence.;Methods: This study was conducted in three ART hospitals in Luxi City, Dehong Prefecture, Yunnan Province. Between August 2010 and January 2011, qualitative in-depth interviews were conducted with 20 currently treated HIV/AIDS patients and 21 of their family members. A cross-sectional survey was conducted among 499 HIV/AIDS patients who were currently being treated with HAART and 302 of their family members.;Results: Patients on HAART who were infected with HIV though injection drug use and were current smokers typically had poorer physical health than other participants on HAART. Better financial status and better physician-patient relationship were associated with both physical and psychological well-being. Family awareness of the patient's HIV status was negatively associated with the patient's psychological well-being. Higher levels of perceived HIV-related stigma were associated with poorer psychological health and poorer family functioning. Of the 302 family members surveyed, 117 were HIV-positive and 72 of those were receiving HAART. Infected family members typically had lower scores on both the physical and mental component summaries of quality of life measurement. Factors associated with a better physical component summary included having better financial status, lighter care-giving burden, a stronger feeling of entrapment, being HIV-negative, and better patient quality of life. Factors associated with a better mental component summary included having better financial status, less tangible support, more affection from others, a lighter care-giving burden, and better patient quality of life. A strong desire to stay alive and concern about the family were the two most important motivations for adhering to treatment. For those with strong motivation, environmental factors and reminder methods to take doses on time were important for treatment adherence, and became deeply ingrained habits that ensure long-term adherence.;Conclusions: In addition to providing HAART only, China's treatment program needs to pay more attention to other medical issues that may have high prevalence among HIV/AIDS population. Moreover, support services should be integrated into existing medical treatment and the services should target both the patients and their families. The national physician training program should include more non-medical components in its training curriculum in order to improve the quality of service. Treatment adherence education should be implemented at the time of HIV diagnosis, and stimulating strong motivation should be the core components. Cooperation within the health system and between different government systems should be improved to ensure the continuum of treatment.
机译：背景：中国的免费抗病毒治疗计划始于2002年的100名艾滋病患者的试点，并在过去八年中迅速发展。截至2010年底，该计划已为100,000多名HIV / AIDS患者提供了治疗。在这种有效的医学干预下，已观察到治疗患者的死亡率显着降低。当前的治疗评估系统严重依赖医学指标，而对HIV / AIDS患者及其家属的动态需求知之甚少，包括HAART时代治疗依从性的支持因素。这项研究的主要目的是了解和评估艾滋病毒/艾滋病患者及其家属的医疗和心理需求，并探讨治疗依从性的支持因素。云南省德宏州西市。在2010年8月至2011年1月之间，对20名目前接受治疗的HIV / AIDS患者及其21名家庭成员进行了定性深入访谈。对目前正在接受HAART治疗的499名HIV / AIDS患者及其302名家属进行了横断面调查；结果：HAART患者通过注射吸毒感染了HIV，并且当前吸烟者的身体状况较差健康程度高于HAART上的其他参与者。更好的财务状况和更好的医患关系与身心健康有关。家庭对患者艾滋病毒状况的意识与患者的心理健康状况呈负相关。较高的被感知的与艾滋病相关的污名与心理健康状况较差和家庭功能较弱有关。在接受调查的302位家庭成员中，有117位HIV阳性，其中72位正在接受HAART。受感染的家庭成员通常在生活质量测量的身体和心理组成部分摘要上得分较低。更好的身体状况摘要相关的因素包括：财务状况更好，护理负担减轻，被困感增强，艾滋病毒呈阴性，以及患者的生活质量更高。与较好的心理状况摘要相关的因素包括财务状况改善，有形支持减少，对他人的感情增加，护理负担减轻以及患者生活质量提高。坚持生存的强烈愿望和对家庭的关注是坚持治疗的两个最重要动机。对于有强烈动机的人，环境因素和及时服药的提醒方法对于依从性治疗很重要，并已成为根深蒂固的根深蒂固的习惯，以确保长期依从性。结论：除了仅提供HAART以外，中国的治疗计划还需要付费更多地关注可能在HIV / AIDS人群中普遍流行的其他医学问题。此外，应将支持服务整合到现有的医疗服务中，服务应针对患者及其家人。国家医师培训计划应在其培训课程中包括更多非医学成分，以提高服务质量。诊断艾滋病毒时应进行治疗依从性教育，激发强烈动机应是其核心组成部分。应当改善卫生系统内部以及不同政府系统之间的合作，以确保连续治疗。

著录项

  • 作者

    Wen, Yi.;

  • 作者单位

    University of California, Los Angeles.;

  • 授予单位 University of California, Los Angeles.;
  • 学科 Asian Studies.;Psychology Social.;Health Sciences Epidemiology.
  • 学位 Ph.D.
  • 年度 2011
  • 页码 124 p.
  • 总页数 124
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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