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首页> 外文期刊>AIDS care. >Adherence to antiretroviral treatment among pregnant and postpartum HIV-infected women.
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Adherence to antiretroviral treatment among pregnant and postpartum HIV-infected women.

机译：孕妇和产后感染艾滋病毒的妇女坚持抗逆转录病毒治疗。

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Among women with HIV infection, pregnancy is a time when maintenance of maternal health and reduction of vertical HIV transmission are primary concerns. Few studies have examined adherence to Antiretroviral Treatment (ART) during pregnancy and in the postpartum period when the demands of childcare may significantly interfere with women's self-care behaviors. This study examined ART use and adherence in HIV-infected pregnant and postpartum women participating in the Women and Infants Transmission Study (WITS-IV) in the US. Adherence was assessed through a self-report interview during the third trimester of pregnancy and six-month postpartum. Data were also collected on demographics, biomedical markers and health related symptoms. During the third trimester visit, 77% (309/399) of women completed the self-report adherence measure; 61% (188/309) reported complete adherence. Factors associated with non-adherence included advanced HIV disease status, higher HIV-RNA viral load, more health-related symptoms and alcohol and tobacco use. At six-month postpartum, 55% (220/399) completed the measure; 44% (97/220) of these women reported complete adherence. Factors associated with non-adherence during the postpartum period were ethnicity, more health-related symptoms and WITS clinical site. Results of multivariate analyses using Generalized Estimated Equation analyses across the two visits revealed that more health-related symptoms, higher HIV-RNA viral load, increased alcohol use and clinical site were independently associated with ART non-adherence. These analyses indicate that medication adherence is more likely during pregnancy than postpartum in HIV-infected women, perhaps provoked by motivation to reduce vertical transmission and/or intensive antepartum surveillance. Further investigation is warranted to clarify factors implicated in women's decision-making process regarding ART medication adherence.
机译：在感染艾滋病毒的妇女中，怀孕是维持孕产妇健康和减少艾滋病毒垂直传播的主要时间。很少有研究检查怀孕期间和产后时期对抗逆转录病毒治疗（ART）的依从性，因为育儿的需求可能会严重干扰女性的自我保健行为。这项研究调查了参加美国妇女和婴儿传播研究（WITS-IV）的HIV感染孕妇和产后妇女的ART使用和依从性。在妊娠晚期和产后六个月通过自我报告访谈来评估依从性。还收集了有关人口统计学，生物医学标记和健康相关症状的数据。在妊娠中期，有77％（309/399）的女性完成了自我报告的依从性测量; 61％（188/309）报告完全遵守。与不依从相关的因素包括艾滋病毒感染状况恶化，HIV-RNA病毒载量较高，与健康有关的症状以及酗酒和吸烟。产后六个月，有55％（220/399）完成了该措施;这些妇女中有44％（97/220）报告完全遵守。产后不依从的相关因素是种族，更多与健康相关的症状和WITS临床部位。在两次访问之间使用广义估计方程分析进行的多变量分析结果显示，与健康相关的症状更多，HIV-RNA病毒载量更高，饮酒量增加和临床部位增加与抗逆转录病毒疗法的依从性独立相关。这些分析表明，感染艾滋病毒的妇女在怀孕期间比在产后更容易坚持药物治疗，这可能是由于减少垂直传播和/或加强产前监测的动机所致。有必要进行进一步的调查，以弄清女性对抗逆转录病毒药物依从性的决策过程所涉及的因素。

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