适应性策略,以保持与艾滋病毒感染者生活在护理中的人
Elvin H Geng1, Thomas A Odeny2, Lina M Montoya3
1Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis, St. Louis.
NEJM evidence
|December 25, 2023
概括
顺序干预改善了人类免疫缺陷病毒 (HIV) 治疗的延续. 条件现金转账 (CCT) 和同行导航是最有效的,特别是当继续为患者没有失误时.
科学领域:
- 公共卫生 公共卫生
- 临床医学 临床医学
- 行为科学 行为科学
背景情况:
- 优化人体免疫缺陷病毒 (HIV) 治疗的延期至关重要.
- 根据患者的反应量身定制的连续行为干预措施可以提高坚持.
研究的目的:
- 评估一系列的行为干预措施,以改善艾滋病毒治疗的保留.
- 将短信服务 (SMS) 和有条件现金转账 (CCT) 与标准护理 (SOC) 的有效性进行比较.
主要方法:
- 一个连续的多重分配随机试验在肯尼亚进行.
- 开始接受艾滋病毒治疗的成年人被分配到SOC,SMS或CCT.
- 有保留缺陷的参与者被重新随机化为SOC外展,SMS+CCT或同行导航.
主要成果:
- 与SMS (71.7%) 和SOC (70.7%) 相比,有条件现金转账 (CCT) 在第一年保持率最高 (79.7%).
- 同行导航和SMS+CCT显著提高了那些已经过期的人的返回率.
- 在没有失误的患者中,持续的CCT显著增加了保留率 (83.5%),相比停止 (60.3%).
结论:
- 积极的干预,包括导航失误和持续的初始干预,产生了最好的保留和病毒抑制.
- 停止使用CCT对病毒的保留和病毒抑制产生了负面影响,与短信不同.
- 该研究强调了在艾滋病毒治疗中适应性,持续性干预措施的重要性.
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