Reasons and countermeasures analysis for HIV-infected patients not receiving antiretroviral therapy in Kunming

Abstract

Objective To investigate the untreated HIV-infected persons in Kunming and analyze the reasons why HIV patients failed to receive highly active antiretroviral therapy (HAART) in Kunming City, so as to provide policy guidance for improving the coverage of treatment and therapeutic adherence.

Methods Questionnaire survey was conducted among HIV/ AIDS patients who survived but did not receive antiretroviral treatment in Kunming City by Aug.31.2018 by random sampling, the survey included general demographic information and reasons for no treatment (including cognition of ART, physical factors, social shame, accessibility of treatment services, attitude towards disease, etc.).

Results A total of 784 HIV-infected patients were effectively investigated, among them, 537 cases (68.5%) were untreated and 247 cases (31.5%) were lost. There was no statistical difference in the general demographic characteristics such as gender, age, nationality and marital status between the two groups ( P>0.05). The infection pathway was statistically significant different ( P<0.05). The analysis results showed that: The main reasons for the untreated HIV-infected patients are fear of exposure, side effects of drugs, selfawareness of good health without treatment. The prejudice rate of the untreated group was higher than that of the lost group ( P<0.05), The proportion of patients who thought that they were in good health and did not need treatment (49.2%) was higher than that in the loss group (34.8%), the difference was statistically significant ( P<0.05); the social shame of the lost group was stronger than that of the infected group ( P<0.05).

Conclusion Governments at all levels and relevant institutions should strengthen publicity of ART effect, guide the infected patients to correctly understand significance of treatment, especially drug addicts, should pay more attention to improve their treatment compliance and reduce loss; should guide the public to reduce discrimination and stigmatization of infected people, reduce social shame, so as to cooperate with doctors for active treatment.

Abstract

摘要：目的 对昆明市未治疗的HIV感染者进行调査, 分析未接受抗病毒治疗的原因, 为制定针对性的干预措施、提髙HIV感染者治疗率及治疗依从性提供参考依据。 方法 采用方便抽样的方法, 抽取昆明市截至2018年8月31日 尚存活但未治疗的HIV感染者进行问卷调査, 调査内容包括一般人口学信息和和未治疗原因 (包括对ART的认知、躯 体因素、社会羞耻感、治疗服务可及性、对待疾病的态度等几个方面)。 结果 有效调査784例HIV感染者, 其中, 未治 者537例(68.5%), 脱失者247例 (31.5%), 两组患者性别、年龄、民族、婚姻状况等一般人口学特征差异无统计学意义( P >0.05), 感染途径有差异统计学意义( P<0.05)。分析结果显示, HIV感染者未治疗原因主要是担心被暴露、药物副作 用、自觉身体状况良好不需要治疗。未治疗组对治疗药物副作用的偏见率较髙( P<0.05), 其认为身体状况良好不需要 治疗的比重(49.2%)髙于脱失组 (34.8%), 差异有统计学意义( P<0.05);脱失组的感染者, 其社会羞耻感更强烈( P<0.05)。 结论 抗病毒治疗机构应加强ART效果宣传, 引导感染者正确认识治疗的作用及意义 , 尤其是吸毒感染者, 应 该给予更多关注 , 以提髙其治疗依从性 , 减少脱失;各级政府和相关机构应引导公众减少对感染者的歧视和污名化, 减 轻社会羞耻 , 以配合医生积极治疗。