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目的:全面了解云南省艾滋病高流行县(市、区)HIV阳性孕产妇孕期服抗病毒药情况及影响因素,为相关卫生主管部门今后促进HIV阳性孕妇孕期规范服药提供科学依据。方法:采用流行病学病例对照研究方法,收集13个高流行县(市、区)的HIV阳性孕产妇孕期服抗病毒药的相关资料。结果:13个县(市、区)共调查了HIV阳性并选择继续妊娠的孕产妇314人,规律服药率为93.3%。对孕期规律服药的影响因素中,对母婴阻断的信心越强服药越规律,与其他服药方案相比AZT+3TC+LPV/r、AZT+3TC+EFV和AZT+3TC+NVP 3种方案更容易规律服药,对生与不生孩子选择的困难程度越大服药越不规律,对预防艾滋病母婴传播知识的了解程度越高服药越规律,敌对情绪越高服药越不规律,对以后孩子的照顾越担心服药越不规律。结论:影响HIV感染孕产妇规律服药的影响因素较一般HIV感染者复杂得多。建议结合产前保健服务,根据患者的具体情况,建立个性化服务和随访方式;加强医患沟通,建立信任关系,优化服药方案。
Objective: To comprehensively understand the situation and influential factors of antiviral drugs during pregnancy during HIV-positive pregnant women in high-prevalence HIV-infected counties (cities and districts) in Yunnan Province, and provide scientific evidences for the relevant health authorities to promote standardized medication during pregnancy for HIV-positive pregnant women. Methods: Epidemiological case-control study was used to collect information on anti-viral drugs used during pregnancy of HIV-positive pregnant women in 13 high endemic counties (cities and districts). Results: A total of 314 pregnant women who were HIV positive and chose to continue pregnancy were surveyed in 13 counties (cities and districts). The regular medication rate was 93.3%. Of the factors that influence the regular medication during pregnancy, the more the confidence of the mother and the child is blocked, the more regular the medication is. Compared with other medication plans, the three programs of AZT + 3TC + LPV / r, AZT + 3TC + EFV and AZT + 3TC + NVP More easily and regularly taking medication, the more difficult the choice between living and not having children The more irregular the medication, the higher the level of knowledge about preventing mother-to-child transmission of HIV / AIDS The more regular the medication, the higher the hostility The more irregular the medication, The more care you take, the less regular you take the medicine. Conclusion: The influencing factors of regular maternal drug taking affect HIV infection are much more complicated than those of general HIV infected persons. It is suggested to establish a personalized service and follow-up mode in combination with prenatal care services according to the specific conditions of the patients; strengthen communication between doctors and patients, establish trust relationship and optimize medication plans.