HIV TREATMENT ADHERENCE TECHNOLOGY: ANALYSIS OF COMMUNICATIONS IN THE SPECIALIST-PATIENT SYSTEM


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Abstract

Objective. To assess the structure and quality of communications on HIV infection treatment according to the results of a survey of HIV-infected patients. Subjects and methods. In 2019-2020, a direct written survey of 437 HIV-infected patients was conducted during continuous sampling at the planned follow-up visit. Surveys were made in 161 patients (Group 1) in the Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan, in 166 patients (Group 2) in the Leningrad Regional AIDS Center, and in 110patients (Group 3) in the Republican AIDS Center, Ministry of Health and Social Development of the Kyrgyz Republic. The respondents were asked to answer indicator questions to assess the fact and content of conversations made by healthcare workers about HIV infection treatment, and also to assess whether there is enough time at the physician’s appointment to investigate treatment issues. Results. A conversation on their treatment was confirmed by 46.9%, 91.5%, and 100% of the respondents in Groups 1, 2, and 3, respectively. The lowest rate of an affirmative answer to this indicator question was observed in Group 1 (p1-2 < 0.001; p1-3 < 0.001). The differences in the rate of this indicator between Groups 2 and 3 were also statistically significant (p2-3 = 0.011). An affirmative answer to all the asked indicator questions was obtained; counseling on HIV infection treatment was in full carried out in 22.4, 34.4, and 14.5% of cases in Groups 1, 2 and 3, respectively. Full-scale counseling was most frequently made in the Leningrad Region (p1-2 = 0.050; p1-3 = 0.049; p2-3 < 0.001). However, only a third of the surveyed participants confirmed that they had received counseling in full. In all the groups, the reasons for an impaired medication regimen were least often discussed with 36.5, 47.5, and 29.1% of respondents in Groups 1, 2 and 3, respectively. Most of the respondents noted that there was enough time to investigate treatment issues at the physician’s appointment: these were 88.4%, 88.4%, and 77.3%, respectively. Conclusion. The findings may suggest that in the regions where the questionnaire survey is conducted, the directive style of communications prevails in the specialist-patient system, and motivating counseling strategies are insufficiently used. There is a deficit in identifying the risks of non-adherence. Clarification and minimization of the risks of non-adherence, the use of incentives that motivate adherence to the antiretroviral therapy regimen, in particular, reminders of the prospect of improving the health status with regular use of drugs, contribute to enhancing the effectiveness of communications on HIV infection treatment.

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About the authors

Valentina V. BELYAEVA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: labora-et-ora@yandex.ru
MD, Leading Researcher, Central Research Institute of Epidemiology Moscow, Russia

Nadezhda V. KOZYRINA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: nad-kozyrina@yandex.ru
Cand. Med. Sci., Senior Researcher, Central Research Institute of Epidemiology Moscow, Russia

Ekaterina V. SOKOLOVA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: ekaterinasokolova007@rambler.ru
Cand. Med. Sci. Moscow, Russia

Svetlana Yu. SEMIKOVA

Center for Prevention and Control of AIDS and Communicable Diseases

Email: semsvet@list.ru
Deputy Head Physician Saint Petersburg, Russia

Niyaz I. GALIULLIN

Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan

Email: centre.spid@tatar.ru
Cand. Med. Sci., Head Physician Kazan, Russia

Aibek A. BEKBOLOTOV

Republican AIDS Center, Ministry of Health and Social Development of the Kirgiz Republic

Email: aibek_0001@mail.ru
Deputy Director Bishkek, Kirgiz Republic

Airat T. BESHIMOV

Republican Center for Prevention and Control of AIDS and Communicable Diseases, Ministry of Health of the Republic of Tatarstan

Email: beshimov@rambler.ru
Cand. Med. Sci., Deputy Head Physician for Outpatient Work Kazan, Russia

Tattygul Ch. BERDALIEVA

Republican AIDS Center, Ministry of Health and Social Development of the Kirgiz Republic

Email: farmang@mail.ru
Therapist, Head, Department of Follow-Up and Treatment Bishkek, Kirgiz Republic

Artem N. NARKEVICH

Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia

Email: narkevichart@gmail.com
MD, Associate Professor, Head, Department of Medical Cybernetics and Informatics; Head, Laboratory of Medical Cybernetics and Management in Healthcare Krasnoyarsk, Russia

Elena P. LEBEDEVA

Center for Prevention and Control of AIDS and Communicable Diseases

Email: elenalebedeva@list.ru
Medical Psychologist Saint Petersburg, Russia

Zoya K. SUVOROVA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: zksu@inbox.ru
Cand, Biol. Sci.; Senior Researcher, Specialized Research Department of AIDS Epidemiology and Prevention Moscow, Russia

Olga N. KHOKHLOVA

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: x.olia79@mail.ru
Cand. Med. Sci., Senior Researcher, Specialized Research Department of AIDS Epidemiology and Prevention Moscow, Russia

Marina M. SHEGAI

N.A. Semashko Research Institute of Public Health

Email: mshegai-rhcf@mail.ru
Professor, MD; Director Adviser Moscow, Russia

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