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Antiretroviral therapy suppresses HIV replication, prevent mobility and mortality. Treatment adherence is needed to achieve therapeutic success, prevent antiretroviral drug resistance and the risk of HIV transmission in the community. This study aims to determine the factors that associated with the adherent of antiretroviral drug treatment of HIV / AIDS patients in four hospitals in Jakarta in 2018-2019. This study was an observational study with a cross sectional design from the baseline data of INAPROACTIVE study (secondary data) from 666 people living with HIV. Treatment compliance was measured by self-report. Data were analyzed using cox proportional hazard regression with STATA12 software. The results showed the proportion of nonadherent by 17.9%, Analysis of determinant factors for compliance with treatment in this study using multivariate cox regression analysis and the magnitude of the effect was expressed in the prevalence ratio (PR) with 95% confidence interval (CI). Our study showed a proportion of ARV treatment adherence ≥ 95% showed 82.1%. This study showed that the socio-demographic factors associated with ARV treatment adherence among people living with HIV who received ARV therapy were gender, age, marital status and HIV transmission route. Clinical factors that have a relationship with adherence of ARV were the variable history of opportunistic infection syphilis and CD4 value. Treatment factors that have a relationship with adherence of ARV were the variable type of ARV regiment and duration of ARV treatment. All these variables were not statistially significant effect with p value > 0.05.
The prevalence of depression in HIV patients are 60% of total cases. Depression is the biggest psychosocial problem in HIV patients due to multiple stressor that makes patients unable to maintain ARV therapy. HIV patients who are depressed will decrease in quality of life. Study aims to determine relationship between depression and quality of life of HIV patients with ARV therapy at public health centre of CST in Bukittinggi at 2023. This study used crosssectional study design that conducted from March to May 2023 with sample size of 76 people. The result of this study showed that depression in HIV patients give a risk about 4,06 (95% CI 1,06 – 15,40) having a poor of quality of life after controlling of age, marital status, HIV transmission and duration of ARV therapy.
ABSTRAK Latar Belakang: Terapi ARV pada ODHA diharapkan dapat menurunkan angka kematian dan kesakitan serta menekan penularan HIV. Untuk mencapai tujuan MDG’s tahun 2015, diharapkan 90% ODHA sudah mendapatkan terapi ARV secara teratur. RSUD Arifin Achmad Pekanbaru telah memberikan terapi ARV sejak tahun 2004 tetapi belum pernah diteliti pengaruh ARV terhadap survival pasiennya. Metode : Penelitian ini menggunakan desain studi kohort retrospektif dengan 319 sampel dan dilakukan selama Mei-Juni 2013. Data penelitian diperoleh melalui data rekam medis RS. Data dianalisis dengan menggunakan analisis survival metode Kaplan-Meier dan dilanjutkan dengan analisis multivariate Hasil: Penelitian menunjukkan bahwa pasien yang memakan ARV secara teratur memiliki survival yang lebih baik. Pasien yang tidak memakan ARV atau memakan ARV tetapi tidak teratur, memiliki risiko kematian sebesar 42,5 kali lebih besar jika dibandingkan dengan pasien yang memakam ARV secara teratur. (p=0,01, 95%CI: 13-138). Jumlah kematian selama pengamatan hanya 5,8% pada kelompok yang teratur memakan ARV, sedangkan pada kelompok yang tidak mencapai 28%. Faktor lain yang turut meningkatkan survival adalah jumlah CD4 pada awal pengobatan >100 sel/mm³(p=0,01, HR=4,39, 95% CI(1,8-10,5). Walaupun kurang bermakna secara statistik, perlu mempertimbangkan pemberian ARV pada stadium klinis awal sebagai faktor yang turut meningkatkan survival ODHA mengingat stadium klinis dapat diperiksa di semua layanan kesehatan. (p=0,07, HR=2.3, 95%CI 0,9-5.6). Faktor pendidikan secara statistik juga bermakna membedakan survival pasien. Dalam penelitian ini stadium klinis dibuktikan sebagai confounding. Hal yang disarankan adalah meningkatkan cakupan penemuan dan tatalaksana dini kasus HIV/AIDS dengan melakukan pelacakan pada semua kasus mangkir, meningkatkan kepatuhan memakan ARV dan mengupayakan pendampingan kasus secara maksimal.
ABSTRACT Background: ARV for HIV or AIDS patients is a hope to reduce the mortality, morbidity and to prevent the transmissions. To achieve the MDG the minister of health need to cover 90% AIDS people with ARV adherently. RSUD Arifin Achmad Pekanbaru have giving the therapy for AIDS patients since 2004, but have never studied the survival analysis and another factors that contribute to yet. Method: This study is a cohort retrospective design, with 319 samples. Take place in Arifin Achmad Hospital Of Pekanbaru, Riau Province in May-June 2013. The resource are medical record of HIV/AIDS patiens in VCT clinic. Was analyse by Kaplan-Meier survival analysis and then for further use multivariate analyses. Result: The study show that the survival of patiens who take ARV adherently is higher than the other one. The patients who no used ARV adherently will have mortality rate 42,5 times than the patients that used ARV addherently. (p=0,01, 95%CI: 13-138). The deaths amount only 5,8% on the adherently ARV patients, but at another side, the deaths amount increase by 28%. Another factor that contribute to increase the survival are CD4 amounts at the beginning of therapy that >100 sel/mm³(p=0,01, HR=4,39, 95% CI(1,8-10,5). We need to consider the clinical of AIDS stadium as one of factor that contribute to increase the survival too if use ARV at the beginner of clinical stadium. (p=0,07, HR=2.3, 95%CI 0,9-5.6). The educations level has the value statistically to distinguish the survival. In this study, the clinical stadium is a confounder. We sugest to improve the early detection and prompt treatment by tracking the lost of follow up patients, increase the adherent of ARV and by mentoring or”buddy” programe for all HIV cases.
