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首页> 外文期刊>Journal of Global Health >The impact of HIV status on the distance traveled to health facilities and adherence to care. A record-linkage study from rural South Africa
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The impact of HIV status on the distance traveled to health facilities and adherence to care. A record-linkage study from rural South Africa

机译：艾滋病毒地位对卫生设施的距离的影响和遵守护理。农村南非的纪录联系研究

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Background For people living with HIV (PLWH), the burden of travelling to a clinic outside of one’s home community in order to reduce the level of stigma experienced, may impact adherence to treatment and accelerate disease progression. Methods This study is set in the Agincourt Health and Demographic Surveillance System (HDSS) in South Africa. Probabilistic and interactive methods were used to individually link HDSS data with medical records. A regression analysis was used to assess whether travel distance was correlated with the condition for which individuals were seeking care (primarily HIV, diabetes or hypertension). For PLWH, a Cox proportional hazard regression model was used to test for an association between the distance travelled to the clinic and late attendance at follow-up visits. Results The adjusted relative risk (RR) of travelling to a clinic more than 5 km from that nearest to their home for HIV patients compared to those being treated for other conditions was 2.78 (95% confidence interval (CI)?=?2.23-3.48). The adjusted Cox regression model showed no evidence for an association between the distance travelled to a clinic and the rate of late visits. (RR?=?1.00, 95% CI?=?0.99-1.00). Conclusions The findings were consistent with the hypothesis that people living with HIV/AIDS would be willing to accept the burden of increased clinic travel distances in order to maintain anonymity and so limit their exposure to stigma from fellow community members. For those seeking HIV care the lack of an association between increased travel distances and late visit attendance suggests this may not impact treatment outcomes.
机译：背景技术与艾滋病毒（PLWH）生活（PLWH），旅行到一个人的家庭社区以外的诊所的负担，以减少耻辱所经历的耻辱水平，可能会影响依从性治疗和加速疾病进展。方法本研究设定在南非的agincourt健康和人口监测系统（HDSS）中。概率和交互式方法用于单独将HDSS数据与医疗记录一起链接。回归分析用于评估行程距离是否与个体正在寻求护理的条件（主要是HIV，糖尿病或高血压）。对于PLWH，使用COX比例危险回归模型来测试在临床和后续访问的临床和晚期出席的距离之间的关联。结果与其他条件治疗的人相比，距离最近的HIV患者最近的诊所的调整后的相对风险（RR）距离最近的HIV患者（95％）（CI）？=？2.23-3.48 ）。调整后的Cox回归模型显示出距离诊所的距离与延迟访问速度之间的关联的证据。 （RR？=？1.00,95％CI？=？0.99-1.00）。结论发现结果与艾滋病毒/艾滋病的人们愿意接受临床旅行距离增加的负担，以保持匿名，并因此限制他们对来自社区成员的耻辱的影响。对于那些寻求艾滋病毒的人来说，缺乏旅行距离和迟到的拜访之间缺乏关联，这可能不会影响治疗结果。

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