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在乌干达农村的家庭艾滋病护理计划中坚持抗逆转录病毒疗法
Paul J Weidle1, Nafuna Wamai, Peter Solberg
1Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. pweidle@cdc.gov
Lancet (London, England)
|November 7, 2006
概括
在非洲农村的家庭抗逆转录病毒疗法 (ART) 计划改善了患者的坚持和病毒载荷抑制. 这些创新型号对于在资源有限的环境中克服艾滋病毒护理障碍至关重要.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 非洲农村地区的贫困和有限的医疗保健机会阻碍了抗逆转录病毒治疗 (ART) 的坚持.
- 基于设施的ART交付和监测在资源有限的环境中面临重大挑战.
- 创新的,以社区为基础的方法对于非洲农村人口有效的艾滋病毒/艾滋病护理至关重要.
研究的目的:
- 评估乌干达农村家庭艾滋病护理计划中对ART的坚持.
- 在这个人群中识别与低于最佳的坚持和病毒负载结果相关的因素.
主要方法:
- 一组987名艾滋病毒感染的成年人患有晚期疾病,通过家庭护理计划接受了ART.
- 坚持干预措施包括团体教育,个性化计划,药物伴侣和每周由非专业人员进行家庭配送.
- 在6个月和12个月,分析了与药丸计数坚持 (PCA) <95%,药物持有率 (MPR) <95%和病毒载量≥1000副本/毫升相关的因素.
主要成果:
- 观察到非常低的不良坚持率:PCA<95%在0.7-2.6%和MPR<95%在3.3-11.1%的参与者中.
- 实现了高病毒负载抑制:<1000副本/毫升,在6个月后98%和12个月后96%.
- 低于最佳的坚持 (PCA <95%或MPR <95%) 与病毒载量升高 (ORs从9.44到14.5) 有着强烈的关联.
结论:
- 基于家庭的艾滋病护理计划可以在资源有限的非洲农村环境中实现良好的坚持和治疗反应.
- 有效的干预措施对于解决全面艾滋病毒/艾滋病治疗的障碍至关重要,特别是对ART的坚持.
- 持续评估和调整医疗保健系统是必要的,以优化艾滋病护理的提供.
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