【摘要】 目的 了解贵州省安顺市HIV/AIDS患者在接受cART治疗过程中出现脱失现象的原因及其影响因素，为HIV/AIDS患者持续接受cART制定政策和措施提供参考依据。方法 采用1∶2匹配病例对照研究设计，对接受cART的HIV/AIDS患者进行面对面调查，将符合纳入排除标准的发生过失访或停药的HIV/AIDS患者作为脱失组，对照组则是从未发生过失访或停药的治疗者中选择符合纳入排除标准和匹配条件的患者；对脱失原因进行描述性分析，并使用条件Logistic回归分析影响治疗脱失的影响因素。结果 研究完成有效问卷调查228人，脱失组76(33.33%)人，对照组152(66.67%)人；男性153(67.11%)人，女性75(32.89%)人，脱失组平均年龄为（57.80±12.03）岁，对照组平均年龄（56.10±11.54）岁；脱失组治疗脱失的主要原因（多选）：身体无症状或服药后症状好转而选择停止服药（50.00%,38/76）、药物不良反应（46.05%,35/76）、每天按时吃药有困难（23.68%、18/76）、领药不方便（21.05%,16/76）；多因素条件Logistic回归分析结果显示家属不赞成患者接受抗病毒治疗（OR=7.26,95%CI:1.31～40.37）、被动领药（OR=473.47,95%CI:16.51～13 579.53）、担心在医院暴露病情（OR=5.65,95%CI:1.29～24.80）、服用抗病毒药物不方便（OR=32.82,95%CI:5.34～201.43）是HIV/AIDS患者在接受cART治疗过程中出现脱失的危险因素。结论 需及时有效地处置患者的药物不良反应、推动治疗服务的扩展延伸、加强对患者及家属的宣传教育、减轻药物服用频率、严格保护患者隐私等措施，能够有效提高患者的服药依从性，从而降低治疗脱失率。更多还原

【Abstract】 Objective To understand the reasons for of combined antiretroviral therapy(cART) dropout among patients with HIV/AIDS and influencing factors in Anshun City, Guizhou Province, and to provide a reference basis for formulating policies and measures for patients with HIV/AIDS to continue receiving cART. Methods Using a 1:2 matched case-control study design, face-to-face interviews were conducted with patients with HIV/AIDS receiving cART.Patients who met the inclusion and exclusion criteria and had a history of loss to follow-up or treatment interruption were categorized into the dropout group, whereas the control group comprised patients who had never been lost to follow-up or treatment interruption, according to the inclusion and exclusion criteria and matching conditions. Descriptive analysis was performed on the reasons for dropout, and conditional logistic regression was used to analyze the factors influencing cART dropout. Results A total of 228 valid questionnaires were completed, with 76(33.33%) from the dropout group and 152(66.67%) from the control group; 153(67.11%) were male, and 75(32.89%) were female. The average age was 57.80±12.03 years for the dropout group and 56.10±11.54 years for the control group. The main reasons for treatment dropout in the dropout group(multiple choices) were the physical absence of symptoms or improvement of symptoms after taking the medication and deciding to stop taking the medication(50.00%, 38/76), adverse drug reactions(46.05%, 35/76), difficulty taking the medication on time every day(23.68%, 18/76), and inconvenience of receiving medication(21.05%, 16/76). Logistic regression analysis showed that family members disapproved of antiviral treatment [odds ratio(OR) =7.26, 95% confidence interval CI: 1.31-40.37], passive medication collection(OR=473.47, 95%CI: 16.51-13 579.53), concern regarding exposure of the disease in the hospital(OR=5.65, 95%CI: 1.29-24.80), and inconvenience in taking the antiviral medication(OR=32.82, 95%CI: 5.34-201.43) were risk factors for dropout among patients with HIV/AIDS receiving c ART. Conclusions Measures including timely and effective management of patients’ adverse drug reactions, promoting the expansion of antiviral treatment services, strengthening publicity and education for patients and their families, reducing the frequency of medication use, and strictly protecting patients’ privacy are needed to effectively improve patients’ adherence to medication, thereby reducing the rate of therapy dropout.更多还原