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首页> 外文期刊>AIDS care. >Social-cognitive correlates of antiretroviral therapy adherence among HIV-infected individuals receiving infectious disease care in a medium-sized northeastern US city
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Social-cognitive correlates of antiretroviral therapy adherence among HIV-infected individuals receiving infectious disease care in a medium-sized northeastern US city

机译：美国东北部中型城市中接受感染性疾病治疗的HIV感染者中抗逆转录病毒疗法依从性的社会认知相关性

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High levels of antiretroviral therapy (ART) adherence are required to achieve optimal viral suppression. To better understand mechanisms associated with ART adherence, this study characterized demographic and social-cognitive correlates of ART adherence among HIV-infected individuals from a medium-sized northeastern US city (n=116; 42% female; 43% African-American). Participants completed an audio computer-assisted self-interviewing survey assessing demographics, social-cognitive constructs, and ART adherence, and the participants' most recent viral load was obtained from their medical charts. Suboptimal ART adherence (taking less than 95% of prescribed medications during the past month) was reported by 39% of participants and was associated with being female, being a minority, and having a detectable viral load. In a hierarchical logistic regression analysis, greater than 95% ART adherence was associated with higher levels of adherence self-efficacy (AOR =1.1; p=0.015), higher perceived normative beliefs about the importance of ART adherence (AOR=1.3; p=0.03), and lower concern about missing ART doses (AOR=0.63; p=0.002). Adherence did not differ based on ART outcome expectancies, ART attitudes, or the perceived necessity of ART. In fact, most participants endorsed positive attitudes and expectancies regarding the need for and effectiveness of ART. Taken together, results indicate that suboptimal adherence remains high among HIV-infected minority women, a subpopulation that experiences particularly high rates of chronic stress due to both illness-specific stressors and broader environmental stressors. Consistent with social-cognitive theory, adherence problems in our sample were linked with deficits in self-efficacy as well as perceived norms and behavioral intentions that do not support a goal of 100% adherence. We suggest that interventions to improve adherence informed by social-cognitive theory (1) target patients who are at risk for adherence problems, (2) provide a supportive environment that promotes high rates of adherence, and (3) address inaccurate beliefs regarding optimal adherence levels.
机译：为了达到最佳的病毒抑制效果，需要高水平的抗逆转录病毒疗法（ART）依从性。为了更好地理解与抗逆转录病毒依从性相关的机制，本研究对美国东北部中型城市（n = 116; 42％的女性; 43％的非裔美国人）的HIV感染者中ART依从性的人口统计学和社会认知相关性进行了描述。参与者完成了一项音频计算机辅助的自我访谈调查，以评估人口统计学，社会认知结构和抗逆转录病毒疗法的依从性，并且参与者的最新病毒载量来自于他们的病历表。 39％的参与者报告了不理想的ART依从性（过去一个月服用少于95％的处方药），并且与女性，少数群体和可检测的病毒载量有关。在分层逻辑回归分析中，大于95％的ART依从性与较高的依从性自我效能感（AOR = 1.1; p = 0.015），对ART依从性的重要性有较高的感知规范性信念（AOR = 1.3; p = 0.03），并减少了对缺少ART剂量的关注（AOR = 0.63; p = 0.002）。遵守ART的预期结果，ART态度或认为ART的必要性没有差异。实际上，大多数参与者对抗逆转录病毒疗法的必要性和有效性表示了积极的态度和期望。综上所述，结果表明，在艾滋病毒感染的少数族裔妇女中，次优依从性仍然很高，由于特定疾病的压力源和更广泛的环境压力源，该亚人群的慢性压力率特别高。与社会认知理论一致，我们样本中的依从性问题与自我效能的缺陷以及不支持100％依从性目标的感知规范和行为意图有关。我们建议通过社会认知理论进行干预以改善依从性（1）针对处于依从性问题风险中的患者;（2）提供促进高依从性的支持性环境;（3）解决关于最佳依从性的不正确信念水平。

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