【摘要】 目的探讨抗病毒随访、治疗和关怀一站式服务模式,对艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(HIV/AIDS病人)治疗依从性的影响。方法建立一站式服务平台,为男男性行为人群(MSM)中的HIV/AIDS病人(ACC组)提供相关服务,对比现行疾病预防控制中心(CDC)治疗服务体系(CDC组),按6项产出指标跟踪评价两组病例的服务效果。结果在CD4T淋巴细胞(简称CD4)≤350个/μL的病例中,两组接受抗病毒治疗的比例差异无统计学意义。在其他5项产出指标中,即:每6个月接受CD4检测的比例[率差12%,95%可信区间(CI):5.1～19.9],抗病毒治疗6-12月后CD4增长的比例(率差26.7%,95%CI:27.8～38.0),抗病毒治疗6-12月后病毒抑制的比例(率差49.9%,95%CI:32.3～67.5),HIV确认到首次CD4检测的时间间隔(log-rankχ2=26.178,P=0.000),首次发现CD4≤350个/μL到抗病毒治疗的时间间隔(log-rankχ2=4.632,P=0.031),ACC组均明显优于CDC组。Logistic回归分析确定,病人分组是预测病人依从性的重要因素。结论以病人为中心的一站式服务模式可以明显增强病人随访与治疗的依从性,虽然研究仅限于单一的目标人群,但该模式对于各类HIV感染人群的抗病毒治疗有借鉴意义。更多还原

【Abstract】 Objective To determine the effectiveness of"one-stop"service model on adherence to antiretroviral treatment and follow-up among human immunodeficiency virus/human immunodeficiency syndrome(HIV/AIDS)infected patients among men who have sex with men(MSM)in a city of central China.Methods To establish a onestop service platform for HIV/AIDS infected patients[(AIDS Care Center(ACC)group]newly confirmed from MSM.Patients in the standard care[Center for Disease Control and Prevention(CDC)group]and ACC group were followed for 6-12months,and six outcomes were measured.Results Among patients with CD4cell count≤350 cells/μL,the proportion receiving antiretroviral treatment(cART)did not differ between two groups.Analysis significantly favored the ACC group over the CDC group across the five other outcomes:the proportion of patients with CD4cell count tested at the six-month interval(difference 12%,95%CI5.1-19.9),the proportion of CD4cell recovery for patients receiving cART for 6-12months(difference 26.7%,95% CI27.8-38.0),the proportion of HIV suppression for patients receiving cART for 6-12months(difference 49.9%,95%CI32.3-67.5),median time from HIV confirmative test to the first test for CD4cell count(log-rankχ2=26.178,P=0.000)and median time from the first test for finding CD4cell count≤350cells/μL to cART initiation(log-rankχ2=4.632,P= 0.031).Logistic regression identified study condition as the only significant predictor of patient adherence.Conclusion Coordinated,patient-centered,one-stop service model can enhance adherence to medical follow-up protocols.Although results are limited to a single demonstration setting and to MSM in one large city in central China,findings lend support to a one-stop care model that may be useful across a variety of HIV care settings.更多还原