Results of assessment of rehabilitation potential of patients taking antiretroviral therapy

Objective. Assessment of the structure of rehabilitation potential of patients taking long-term antiretroviral therapy (ART) to clarify the prognosis of adherence to follow-up care and treatment of HIV infection.

Materials and methods. A total of 147 HIV-positive respondents (70.1% men) were interviewed. The median (Me) age was 43 years, the Me duration of life with HIV was 12 years. All respondents were taking ART, the Me duration of treatment was 10 years, the CD4⁺ lymphocyte level was 605 [497–802] cells/μl. 42.0% of respondents had experience of using psychoactive substances (including alcohol). The study used the “Rehabilitation Potential of the Individual” method. Patients were also asked indicator questions about the number and reasons for missing ART doses in the previous month, the frequency of therapy, and the number of pills taken per day. Patients assessed their health using a 10-point visual analogue scale (VAS).

Results. The obtained value of the rehabilitation potential (RP) ranged from 17.9 to 89.3%. In 43.5% of respondents, the RP value was in the range of 42–56 points (75–100%). Only 10 (6.8%) patients had a RP value of 50% or less. The most favorable results were obtained on the scale of the self-assessment component of RP, and the least favorable ones were obtained on the scale of the communicative component. Most values of self-assessment of health on a 10-point VAS were high: 8–10 points (70.1%), which allows to assess the prognosis of visiting a doctor and taking ART as favorable. 35.2% of respondents missed ART in the month preceding the survey. The largest proportion (59.3%) of the reasons for missing doses was associated with forgetfulness. The self-assessment of health indicator statistically significantly positively correlated with the overall level of rehabilitation potential (p = 0.0001), the internal picture of the disease (p = 0.0001), the motivational component of RP (p = 0.001), and statistically significantly negatively correlated with missed ART intake per month (p = 0.0001), the frequency of ART intake (p = 0.001), the number of pills taken (p = 0.003).

Conclusion. It is suggested that patients who rated their health at 5 points or less were more likely to miss ART intake, including due to insufficient resources. It is advisable to assess the risks of impaired adherence to treatment and the possibilities of maintaining it, as well as discuss a plan of measures aimed at retaining the patient in follow-up care and treatment of the disease.