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研究生: 林偉霖
Wei-Lin Lin
論文名稱: 使用海洛因與安非他命之愛滋感染者在美沙冬與HAART之順從性研究
A study of methadone maintenance treatment and HAART adherence amongst HIV infected heroin and amphetamine users.
指導教授: 李思賢
Lee, Szu-Hsien
學位類別: 碩士
Master
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2015
畢業學年度: 103
語文別: 中文
論文頁數: 64
中文關鍵詞: 存活分析美沙冬療法服藥順從性雞尾酒療法藥癮愛滋感染者
英文關鍵詞: Highly active antiretroviral therapy, Injecting-drug users, Medical adherence, Methadone maintenance therapy, Survival analysis
DOI URL: https://doi.org/10.6345/NTNU202205586
論文種類: 學術論文
相關次數: 點閱:391下載:74
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  • 本研究之目的為了解藥癮愛滋感染者在美沙冬治療與雞尾酒療法之服藥順從情形,並探討美沙冬治療是否提升研究對象雞尾酒療法之順從性。本研究採用衛生福利部疾病管制署次級資料,分析2007-2012年之間感染愛滋病毒且發展出AIDS之藥癮者,並藉由卡方、t-test、二元羅吉斯回歸分析背景變項與HIV/AIDS事件的關係,此事件定義係依研究對象CD4高低分為兩組;而存活分析則解釋藥物組別(兩者皆參加、兩者皆未參加、僅參加美沙冬療法、僅參加雞尾酒療法)與HIV/AIDS感染天數之關係,該感染天數定義為自感染HIV至發展出AIDS之天數,最後分析美沙冬參與天數與美沙冬及雞尾酒療法服藥順從性之關係。
    本研究共分析258人,結果顯示婚姻狀態與發展出HIV/AIDS有顯著差異;存活分析部分,HIV感染天數越長與不同藥物治療組別有相關,而參與美沙冬天數、美沙冬服藥順從性及雞尾酒療法服藥順從性有相關。本研究建議醫療院所相關人員應減少個案對於愛滋感染的疑慮以及增加個案對於藥癮問題的認識,此外當個案對於美沙冬有所疑慮時應立即給予釐清,並且給予個案正向鼓勵以增強其服藥順從性。

    In this study is examine whether methadone maintenance therapy (MMT) increased highly active antiretroviral therapy (HAART) adherence among a cohort of HIV-infected injection drug users (IDUs) and who is develop AIDS . We obtained demographic, MMT and HAART taking history from the Taiwan Centers for Disease Control (Taiwan CDC). There were 258 IDUs participants who accessed MMT from 2007-2012. We using Cox proportional hazards regression to examine the independent associations between MMT taking days and the HAART adherence; MMT adherence.
    Our finding is engagement in MMT was positively associated with HAART adherence (b=0.006, 95% CI: 1.001-1.010, p<.05), but negatively associated with MMT adherence (b=-0.33, 95% CI: 9.57-.978, p<.001). These results is that engagement in MMT can benefit against ART discontinuation. We suggestion the medical institutions personnel give IDUs encouragement to enhance medication adherence.

    致謝 I 摘要 II Abstract III 目錄 IV 表目次 VII 圖目次 VIII 第一章 緒論 1 第一節 研究背景 1 第二節 研究動機 4 第三節 研究目的 6 第四節 研究假設 6 第五節 名詞解釋 7 第二章 文獻探討 9 第一節 感染人類免疫缺乏病毒之現況 9 第二節 藥物濫用現況 15 第三節 愛滋感染與藥物濫用之相關研究 21 第四節 美沙冬療法與注射藥癮者之關係 22 第五節 高效能抗反轉錄病毒療法與愛滋感染者相關研究 26 第六節 高效能抗病毒療法和美沙冬療法與藥癮者相關研究 30 第七節 小結 31 第三章 研究材料與方法 32 第一節 理論基礎 32 第二節 研究架構 34 第三節 研究對象 35 第四節 研究工具 35 第五節 研究倫理考量 35 第六節 相關變項操作定義 36 第七節 研究資料處理 39 第四章 研究結果 40 第一節 背景變項與藥物治療相關變項現況 40 第二節 背景變項與HIV/AIDS事件差異分析 43 第三節 治療組別與HIV/AIDS事件差異分析 45 第四節 存活分析 46 第五章 結果討論 48 第一節 不同藥物組別與HIV/AIDS發病進程之相關性 48 第二節 美沙冬服藥天數與雞尾酒療法順從性之相關性 49 第六章 結論與建議 51 第一節 結論 51 第二節 研究建議 52 第三節 研究限制 53 參考文獻 54 附錄一 個案篩選流程 62 附錄二 研究倫理通過證明函 63 附錄三 各資料庫所提供研究相關變項清單 64

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