强化优点个案管理模式对低依从性HIV/AIDS患者抗病毒治疗效果的研究

Objective To investigate the effect of strengths-based case management model on medication adherence and antiviral therapy outcomes among HIV/AIDS patients with low medication adherence. Methods A baseline survey was conducted on 1916 HIV/AIDS patients under followup care at the Antiviral Treatment Clinic of Santai County People's Hospital before December 31, 2024. Patients with an MMAS8 score<6 were defined as having poor medication adherence, from whom 191 subjects were enrolled. Using a randomized controlled trial design, the participants were assigned to the routineintervention group(91 cases) and the individualized casemanagement group(100 cases). Changes in medicationadherence scores and therapeutic efficacy(viral load ≤1000 copies/mL) before and after intervention were compared between the two groups. Results In the baseline survey, the overall treatment success rate among the 1 916 patients was 91.86%, whereas the rate was only 9.97% for patients with MMAS8 scores<6. Among the 191 poorlyadherent patients, the leading causes of nonadherence were longterm medication aversion(20.94%), irregular medication access due to migrant work(17.80%), and adverse drug reactions(16.75%). After oneyear intervention, the proportion of patients achieving the maximum adherence score of 8 rose from 0.0% to 79.0% in the casemanagement group, which was significantly higher than 54.9% in the routineintervention group(P<0.05). Only 7.0% of patients in the casemanagement group still had adherence scores<6, versus 27.5% in the routineintervention group(P<0.05). For treatment efficacy, the casemanagement group saw an increase from 69.0% to 91.0%(a 22.0 percentagepoint rise); the routineintervention group increased from 71.4% to 76.9%(a 5.5 percentagepoint rise). The postintervention difference in treatment efficacy between groups was statistically significant(P<0.05). Conclusion The strengths-based case management model can markedly improve medication adherence and antiviraltreatment efficacy among poorlyadherent HIV/AIDS patients, and outperforms routine intervention. This model is worthy of promotion and application in primary level HIV/AIDS prevention and control programs.