HIV Antiviral Treatment Status And Influencing Factors Among Drug User With HIV And HCV Co-infection At Two District In YunNan Province

ObjectiveTo analyze the current status and influencing factors of HIV antiviral therapy for drug users with HIV and HCV co-infection in Yunnan province.MethodsDuring July-December 2016,a cross-sectional study was conducted among subjects who was decided by convenience sampling at 7 methadone maintenance treatment clinic and 2 Kunming compulsory detoxification Institute in Dali and Kunming,610 addicts with HIV and HCV infection were investigated,581 questionnaire are effective.Chi-square test or T-test was used as single factor analysis,Logistic regression was used as multifactor analysis.ResultsA total of 600 people were surveyed,and 581 valid questionnaires were collected,recovery rate is 96.8%.The rate of antiretroviral therapy was 74.4%(432/581).The top three of the specific reasons for untreated were all attributable to the field of "lack of understanding of disease and treatment".Univariate analysis showed that age,nationality,marriage,education level,annual income,main economic source,medical insurance,habitual residence,depression,course of disease and social support score were the influencing factors of HAART acceptance.Logistic regression analysis showed that:ethnic minorities(OR=0.486,95%CI:0.296-0.798),the main source of income for civil relief(OR=0.394,95%CI:0.238-0.652),duration of more than 8 years HIV infection(OR=0.474,95%CI:0.319-0.705),social support score>19(OR=0.558,95%CI:0.373-0.834)of the subjects were more likely to receive HAART.Among the 581 respondents,the proportion of receiving HCV treatment was 4.3%(25/581),In 556 cases of unaccepted HCV treatment,31.8%(177/556)did not know that they were infected with HCV,All 581 cases knew that they had been infected with HIV,and 74.4%(432/581)had received HIV antiviral treatment,94.2%(407/432)did not receive HCV treatment in people receiving HIV antiviral therapy.Because of the limitation of medical,none of the subjects from the compulsory detoxification institute received HCV treatment.A result of univariate analysis of 310 subjects who knew they have infected with HIV/HCV and knew that they were infected with HIV/HCV and currently in the methadone maintenance treatment clinic show that the annual income HCV knowledge level,social support,whether the doctor have provided HCV treatment recommendations,whether they have received HIV treatment or HCV RNA test,education level were the factors that influenced HCV treatment(p<0.05).Logistic regression analysis showed that subjects who knew HCV(OR=0.376,95%CI:0.150-0.942),have received HCV RNA test(OR=0.407,95%CI:0.168-0.983),were often recommended receiving HCV treatment by doctor(OR=0.343,95%CI:0.105-1.115)were more likely to receive HCV treatment.ConclusionThe rate of receiving HIV antiviral treatment among people with HIV and HCV co-infected was higher than before.Longer time of diagnosis,higher social support and receiving Civil relief are all promoting factors.The rate of receiving HCV treatment is very low,in addition to the HCV inform,and HCV treatment accessibility,patients unable to bear the cost is the most important factor.The HCV nucleic acid test,the doctor’s advice,and the patient’s own cognition of the disease and social support were also the influencing factors of receiving HCV treatment.It is suggested to strengthen the knowledge education of HIV and HCV,improve the information service of HCV test results,improve the treatment transfer system of the detoxification institute,the methadone clinic and the hospital,and try to explore the mechanism of reducing or reducing the cost of the antiviral treatment of the HCV from the aspects of medical insurance system,government relief and the distribution of medical resources.