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目的了解四川省凉山州成人艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(HIV/AIDS病人)中,已接受抗病毒治疗(ART)的病人退出治疗的原因及影响因素,为今后更好地提高民族欠发达地区ART依从性提供依据和参考。方法选取凉山州HIV/AIDS病人退出治疗较严重的两个县作为研究现场,对符合纳入标准的研究对象采用自行设计的问卷进行调查,采用Logistic回归分析相关影响因素。结果 488名调查对象中,退出ART的病人占37.91%(185人),维持ART的病人占62.09%(303人)。能够维持ART的最主要原因是:认为接受ART后可以延长生命的占68.98%(209/303);退出治疗的主要原因是:外出务工领药不方便占30.27%(56/185),强制戒毒停药17.84%(33/185),药物不良反应12.43%(23/185)和由于农忙等原因未去领药11.35%(21/185)。多因素Logistic回归分析显示,服药后外出务工[比值比(OR)3.823,95%可信区间(CI):2.384~6.131]、男性(OR=1.839,95%CI:1.133~2.983)、服用过中药(OR=1.836,95%CI:1.097~3.071)、就医不便捷(OR=1.694,95%CI:1.002~2.866)是退出ART的危险因素;而病人在ART过程中得到家人支持(OR=0.250,95%CI:0.093~0.671)、接受过ART服药依从性教育(OR=0.107,95%CI:0.044~0.260)、ART知识(按得分≥5分计)(OR=0.203,95%CI:0.095~0.434)是HIV/AIDS病人退出ART的保护因素。结论针对HIV/AIDS病人退出ART的问题,可通过完善抗病毒治疗的异地转介机制、推进戒毒所内ART的开展、加强ART人群的依从性教育等措施来改善。
Objective To understand the causes and influencing factors of withdrawal from ART patients who have been infected with HIV / AIDS patients in Liangshan Prefecture of Sichuan Province for better future Provide reference and basis for improving ART compliance in underdeveloped regions of China. Methods The HIV / AIDS patients in Liangshan Prefecture were withdrawn from treatment in two counties with severe treatment. The subjects who met the inclusion criteria were investigated by self-designed questionnaires. Logistic regression analysis was used to analyze the related factors. Results Out of 488 respondents, 37.91% (185) quit ART patients and 62.09% (303) patients who maintain ART. The main reasons for maintaining ART are as follows: 68.98% (209/303) believed to be able to prolong life after receiving ART; the main reasons for withdrawal from treatment are: 30.27% (56/185) 17.84% (33/185) were discontinued, 12.43% (23/185) were adverse drug reactions, and 11.35% (21/185) did not receive any drugs due to busy farming. Multivariate Logistic regression analysis showed that the proportion of migrant workers who took the drug after taking medicine [odds ratio (OR) 3.823, 95% confidence interval (CI): 2.384-6.131], male (OR 1.839, 95% CI 1.133-2.983) (OR = 1.694, 95% CI: 1.002-2.866) were the risk factors for withdrawal from ART. However, patients received family support during ART (OR = 1.836, 95% CI: 1.097-3.071) (OR = 0.107, 95% CI: 0.044-0.260), ART knowledge (score≥5 points) (OR = 0.203, 95% CI: 0.250, 95% CI: 0.093-0.671) : 0.095 ~ 0.434) is a protective factor for withdrawal of ART from HIV / AIDS patients. Conclusion The withdrawal of ART from HIV / AIDS patients can be improved through perfecting the remote referral mechanism of antiviral therapy, promoting the ART in detoxification centers and strengthening the compliance education of ART population.