Study On Canonical Medication Level And Correlates For Antiretroviral Therapy In HIV/AIDS Prevention Mother-To-Child Transmission

OBJECTIVES To understand the status of canonical medication and identify the correlates for canonical medication in antiretroviral therapy for preventing mother-to-child transmission of HIV(PMTCT),so as to contribute to future design of interventional measures to increase canonical medication in PMTCT.METHODS Analying the case records about antiretroviral therapy of PMTCT in 5 HIV high or mid epidemic counties(city and district)in Yunnan from January 2005 to June 2007 to understand the status of canonical medication in antiretroviral therapy in PMTCT.The clues of correlates for canonical medication in antiretroviral therapy were explored by group-interview to docters and HIV positive mothers.Questionnaire survey was conducted to HIV positive mothers and PMTCT staff at county level.Case-control study was used to examed the correlates of the rational selection of antivirus-therapy regimen and the compliance.Personal in-depth interview was used to under the correlates deeply.RESULTS The case records of 167 HIV positive mothers in PMTCT were reviewed. In which,65.9%(110/167)of mothers were canonical medication.The percentage of rational selection of antivirus-therapy regimen was 88.0%(147/167).HIV positive mothers with rational use medicine during labour covered 81.4%(131/161).87.4% (146/167)of women demonstrated good compliance.HIV positive mothers with combined regimen account for 50.9%(85/167).A total of 158 mothers and 57 PMTCT staff were questionnaire surveyed,and 18 mothers,15 PMTCT staff and 2 informers were involved in personal in-depth interview quantitative and qualitive study indicated that:(1)The correlates of rational selection of rational selection of antivirus-therapy regimens included the correlates of rational selection of antivirus-therapy regimens included times of delivery(OR=3.135),minorities(OR=3.393),the antivirus-therapy regimen were selected by doctors(OR=0.329),not informed choice(OR=5.745),the will of preventing transmission from mother to child,doctors' cognition about the regimen.(2)The correlates of the compliance of HIV positive pregnant women were as follows:times of delivery(OR=4.451),minorities(OR=3.733),mother without confident to PMTCT(OR=2.657),regimen of antiretroviral therapy(OR=3.873),not informed choice(OR=10.440),and the will of preventing transmission from mother to child.CONCLUSIONS The level of canonical medication in PMTCT antiretroviral therapy is not high.Canonical medication is associated with multiple correlates from doctors,patients,community and society.It is necessary to make up measure to improve canonical medication of antiretroviral therapy in PMTCT.