nonadherence to primary prophylaxis against pneumocystis jirovecii pneumonia不依从初级预防对卡式肺肺炎.pdfVIP

Nonadherence to Primary Prophylaxis against Pneumocystis jirovecii Pneumonia 1 1 1 2 James D. Heffelfinger *, Andrew C. Voetsch , Glenn V. Nakamura , Patrick S. Sullivan , A. D. McNaghten1, Laurence Huang3 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 2 Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America, 3 HIV/AIDS Division and Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America Abstract Background: Despite the effectiveness of prophylaxis, Pneumocystis jirovecii pneumonia (PCP) continues to be the most common serious opportunistic infection among HIV-infected persons. We describe factors associated with nonadherence to primary PCP prophylaxis. Methodology/Principal Findings: We used 2000–2004 data from the Supplement to HIV/AIDS Surveillance (SHAS) project, a cross-sectional interview project of HIV-infected persons $18 years conducted in 18 states. We limited the analysis to persons who denied having prior PCP, reported having a current prescription to prevent PCP, and answered the question ‘‘In the past 30 days, how often were you able to take the PCP medication(s) exactly the way your doctor told you to take them?’’ We used multivariable logistic regression to describe factors associated with nonadherence. Of 1,666 subjects prescribed PCP prophylaxis, 305 (18.3%) were nonadherent. Persons were more likely to be nonadherent if they reported using marijuana (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI] = 1.1–2.4), non-inj