Adherence To Antiretroviral Therapy, Anxiety And Depression Of AIDS Patients In Anhui, China

ObjectiveThe aim of the study is to investigate the medication adherence of antiretroviral therapy, anxiety and depression status in HIV/AIDS patients in Anhui province, and explore the possible related factors. The study could provide effective information and basis theory guideline for the government to manage the treatment of AIDS.MethodsThis study contained both quantitative investigation and qualitative interview. Quantitative questionnaire survey was conducted in HIV infected individuals being treated in 3 cities of Anhui province. The questionnaire included sociodemographic characteristics, knowledge of AIDS, infection status, information of treatment, ART adherence, anxiety and depression. The software Epi data 3.0 and SPSS 13.0 were used to perform the analysis. Univariate and multivariate logistic regression analysis were used to identify the possible factors associated with ART adherence, anxiety and depression status. Spearman rank correlation analysis was used to assess the association between anxiety, depression status and ART adherence. Qualitative interviews with CDC staffs and HIV-infected people were conducted to analyze the existing problems and solutions in the process of ART.ResultsA total of 298 eligible questionnaires were collected, and the eligible rate was 97.1%. The mean age of the HIV-infected people was 42.43±10.55. Among those individuals, 83.6% were irreligious, 71.5% were junior middle school graduates or lower education, 58.7% were married or cohabitation, 24.2% lived alone and 43.6% families received monthly income lower than 1000 Yuan. The awareness rate of AIDS knowledge was 97.7%. The main access to knowledge was medical workers. More than half of the patients(58.1%) were infected by sexual transmission. 32.9% had received ART for more than five years. Most respondents(92.3%) felt better after starting ART. Some gender differences were observed in the distribution of occupation, education, marital status, habitation conditions, family income, medical insurance, alcohol intake and smoking during the last month, route of infection, duration of diagnose and duration of receiving ART(P<0.05).76.5% of the respondents were reported adherent to ART. Multivariate logistic regression analysis showed that older age, religious belief and drinking alcohol during the last month were barriers to medication adherence. The factors that had the positive impact on ART adherence were being married, received education about ART and being awareness of free antiretroviral treatment. Of all the HIV-infected people, 21.1% were anxiety, 42.3% were depression. By multivariate logistic regression analysis, female and employees of enterprises and institutions were protective factors of anxiety, and religious belief was a risk factor; being married and knowing ART need lifelong medication were protective factors of depression, and work in the business and service jobs was a risk factor. By Spearman correlation tests between depression and ART adherence, depression had negative correlation with ART adherence(P<0.05). The qualitative research indicated that, the drug reactions, the inconvenience of takingmedicine, the social discrimination and self-abandonment were risk factors of non-adherence; the help and encouragement from family and doctors, the desire to survive were protective factors to adherence.ConclusionsThe awareness of basic knowledge of AIDS among HIV-infected individuals in the three cities was high, and the ART adherence rate was low. The scores of both anxiety and depression were higher than the national norm. Age, religious belief, marital status, alcohol intake, received education about ART and being awareness of free antiretroviral treatment were significantly associated with ART adherence. Sex, occupation and religious belief were significantly associated with anxiety. Occupation, marital status and knowing ART need lifelong medication were significantly associated with depression. In the process of AIDS prevention and control work, efforts to support and maximize adherence should be strengthened. Developing adherence guidance and education are important steps. Regulating the guidance and management of HIV/AIDS patients, so as to improve the ART adherence, achieve good treatment effects, and promote the physical and mental health of AIDS patients.