Study On The Status And Influencing Factors Of HIV/AIDS Patients With Low Level Viremia After HAART In Dali

ObjectiveTo investigate the status of post-HAART LLV in HIV/AIDS patients in Dali area,and to explore the related factors of HIV/AIDS patients with low viremia after HAART,to explore its clinical significance,and to propose the corresponding measures to provide some theoretical support for clinical treatment in the future.Methods1.Cross-sectional survey: to understand the status and influencing factors of LLV in HIV/AIDS patients after HAART in Dali area,and to design a questionnaire according to the content of this study,they included General Information Questionnaire,Community Programs for Clinical Research on AIDS Antiretroviral Medication SelfReport(CCRA),and eight-item Morisky medication compliance scale(MMAS-8).2.Semi-structured interview method: On the basis of literature research and expert consultation,the outline of interview for LLV patients among HIV/AIDS patients in Dali and the outline of interview for AIDS doctors and nurses in Dali were compiled.The semi-structured interview was conducted in one-to-one format,and the interview data were sorted out by NVIVO software,and the data were analyzed by descriptive phenomenology method.Through the interview,the influencing factors were fully explored from the point of view of doctors,nurses and patients.Results1.The incidence of post-HAART LLV in HIV/AIDS patients in Dali was 4.0%.2.Univariate analysis showed that gender,smoking status,alcohol consumption,baseline CD4 count and last CD4 count,"During treatment,when you felt that your symptoms were worsening or other symptoms,did you reduce the dosage or stop taking antiviral drug without telling your doctor?" and "Do you think it is difficult to remember to take antiviral drug on time and on time?" were the risk factors for LLV after Haart among HIV/AIDS patients in Dali,there was significant difference(P < 0.05).Pearson correlation analysis showed that the score of MMAS-8 was negatively correlated with the last viral load(r =-0.082,P= 0.102 > 0.001).Multivariate analysis showed that frequent alcohol consumption(OR = 5.307;95% CI: 1.214～23.190),last CD4 cell count(OR=0.996;95% CI: 0.993～0.999),and “No self-medication reduction or discontinuation of antiviral drug when symptoms became more severe during treatment”(OR = 0.097;95%CI: 0.009～1.003)were significantly associated with LLV.3.The results of interviews with HIV/AIDS patients who developed LLV after Haart in Dali area can be summarized into four themes: poor drug compliance(failure to take drugs according to Doctor’s advice,self-withdrawal due to physical discomfort),negative attitude toward life,insufficient knowledge of the disease,and changes in drug regimen.The results of interviews with AIDS doctors and nurses in Dali area can be summed up into three themes: poor drug compliance,insufficient knowledge of the disease and drug resistance.ConclusionThe incidence of low viremia in HIV/AIDS patients after HAART is low in Dali.Frequent drinking is a risk factor for LLV in HIV/AIDS patients after Haart in Dali,a recent high CD4 count and "Reducing the dose or stopping the antiviral drug without telling your doctor when you feel your symptoms are getting worse or other symptoms during treatment" were protective factors.HIV/AIDS patients should take medicine on time and in accordance with their dosage,develop good living habits,drink less alcohol and take proper exercise to strengthen their immunity.Health care workers should popularize relevant knowledge,advocate patients to drink less and inform patients of the importance of taking medicine on time,improve the medical security system to reduce the incidence of LLV.