摘要目的 分析2015年伊犁哈萨克自治州(伊犁州)乡级艾滋病治疗机构内HIV感染者和艾滋病患者抗病毒治疗(ART)依从性及影响因素.方法 本研究以伊犁州3个乡级(喀尔墩乡、塔什库勒克乡和愉群翁乡)艾滋病治疗机构为研究现场,于2015年5月,由从事艾滋病治疗的工作人员进行研究对象招募,纳入研究场所内18岁及以上、既往确认HIV抗体阳性且正在接受抗病毒治疗(ART)、签署知情同意书并接受问卷调查者,共443例.剔除问卷填写不完整或不符合逻辑者,最终纳入研究对象412例.采取自行设计的问卷调查和查询艾滋病综合防治信息系统相结合的方式进行调查,调查内容包括社会人口学特征、ART认知和ART依从性情况、参加"恰依"活动(当地流行的一种民间聚会活动)、家人告知、吸烟和饮酒状况.采用《世界卫生组织生存质量测定量表中文版介绍及其使用说明》对其生存质量进行评定.采用χ2检验对研究对象抗病毒治疗依从性进行单因素分析;采用多因素二分类非条件logistic回归分析模型对研究对象抗病毒治疗依从性进行多因素分析.结果 412例研究对象的年龄为(41.1±8.0)岁,范围为19~67岁;男性占60.9%(251例),女性占39.1%(161例);依从ART者占75.0%(309例),其生存质量得分的P50(P25,P75)为56.31(50.55,59.42)分.单因素分析显示,男性ART依从率[70.1%(176例)]低于女性[82.6%(133例)](χ2=8.16,P=0.005);有抑郁状况者ART依从率[78.0%(54例)]高于无抑郁状况者[63.5%(255例)](χ2=7.52,P=0.008).多因素分析结果显示,生存质量得分较高者依从ART的可能性较高(OR=1.06,95%CI:1.02~1.09);饮酒和告知家人HIV感染状况者依从抗病毒治疗可能性较低(OR=0.26,95%CI:0.13~0.53;OR=0.31,95%CI:0.13~0.72);与无业者相比,职业为工人者依从ART的OR(95%CI)值为0.45(0.21~0.97).结论 伊犁州部分乡艾滋病治疗机构内HIV感染者和艾滋病患者ART的依从性较好;饮酒、告知家人HIV感染状况、工人职业和生存质量为影响机构内HIV感染者和艾滋病患者依从ART的相关因素.

abstractsObjective To analyze factors influencing antiretroviral therapy (ART) adherence among human immunodeficiency virus (HIV) patients receiving ART at the town level in Ili Kazakh Autonomous Prefecture (Ili) in May 2015 and to document enhanced ART for acquired immunodeficiency syndrome (AIDS) cases. Methods A cross-sectional survey was conducted using one-on-one interviews and data collection from the system of AIDS follow-up management in three ART services centers at the town level of Ili. The subjects were HIV-infected individuals, aged 18 years or older, who were receiving ART during the survey. The surveys collected demographic characteristics, information related to ART and status of engaging ART, smoking and drinking behavior, depression, and quality of life. Results A total of 412 participants completed the survey. The age was (41.1±8.0) years (range, 19-67 years). Approximately 60.9%(251) were male and 39.1%(161) were female. The survey showed that 75.0%(309) of participants were in good adherence and the P50 (P25, P75) of quality of life was 56.31 (50.55, 59.42). Females demonstrated better adherence to ART (82.6%(n=133)) than males (70.1%(n=76)) (χ2=8.16, P=0.005). The compliance rate of participants (78.0% (n=54)) with depression was higher than non-depressed participants (63.5% (n=255)) (χ2=7.52, P=0.008). Multivariate logistic regression analyses showed that the probability of good adherence to ART increased with increasing quality of life (OR=1.06, 95%CI:1.02-1.09). Moreover, participants who consumed alcohol or disclosed their HIV infection status to families were less likely to have good adherence to ART (OR=0.26, 95% CI:0.13- 0.53 and OR=0.31, 95% CI:0.13- 0.72, respectively). Additionally, employed participants were also less likely to have good adherence to ART compared with unemployed participants (OR=0.45, 95% CI:0.21- 0.97). Conclusion HIV/AIDS patients primarily showed good adherence to ART. Factors related to ART adherence included alcohol consumption, informing family of infection, work status, and quality of life.