CD4+ dan Faktor yang Memengaruhi Kepatuhan Terapi Antiretroviral pada Orang dengan HIV/AIDS di Jayapura

Abstract

Abstract Acquired Immune Deficiency Syndrome (AIDS) is one of the leading health problems in Papua and antiretroviral (ARV) therapy increases cluster of differentiation 4 (CD4+). We examined whether the CD4+ counts correlated with factors affecting adherence of ARV therapy in Papua. A cross-sectional study was conducted from June to September 2017 at VCT RSUD Dok II Jayapura. We assessed 85 respondents receiving ARV therapy for 12-24 months, who had fulfilled inclusion criteria agreed to sign the informed consent. Information of CD4+ and factors affecting adherence were obtained from blood samples analysis and questionnaires. Data were analyzed using Fisher exact test and Odds Ratio at p<0,05. The result showed that the high percentages of respondents’ characteristics include female, aged 15-30 years, employed, had formal education, indigenous Papuan, good treatment knowlegde, never switch ARV, had ARV side effects, had health insurance, never stigmatized, always got adherence counseling, easy access to health services, had family support, no community support. Most of the respondents were adherent to taking ARVs and had an increase in CD4+ cell counts. Women, working status, and stigma had a greater risk for immunodeficiency. Evaluation was required for respondents whose good adherence but did not experienced an increase in CD4+ cell counts. Keywords : CD4+, factors affecting adherence, ARV therapy, HIV/AIDS, Jayapura Abstrak Acquired Immune Deficiency Syndrome (AIDS) menjadi salah satu permasalahan kesehatan di Papua. Terapi antiretroviral (ARV) meningkatkan jumlah Cluster of Differentiation 4 (CD4+). Penelitian bertujuan menganalisis hubungan CD4+ dengan faktor yang memengaruhi kepatuhan terapi di Papua. Sampling dilakukan Juni sampai September 2017. Responden 85 pasien terapi ARV 12-24 bulan di VCT RSUD Dok II Jayapura yang telah memenuhi kriteria inklusi dan setuju untuk menandatangani informed consent. Data CD4+ dan faktor kepatuhan diperoleh dari pemeriksaan sampel darah dan kuesioner. Data dianalisis dengan uji Fisher exact dan Odds Ratio pada p <0,05. Hasil menunjukkan bahwa persentase karakteristik responden terbesar adalah perempuan, berumur 15-30 tahun, bekerja, sekolah dan asli Papua. Informasi berkaitan dengan ARV dengan persentase terbesar adalah pengetahuan pengobatan baik, tidak pernah ganti ARV pernah mengalami efek samping ARV, memiliki jaminan kesehatan, tidak pernah mengalami stigma, selalu mendapat konseling kepatuhan, akses layanan kesehatan mudah, mendapat dukungan keluarga, tidak mendapat dukungan komunitas. Mayoritas responden patuh minum ARV dan mengalami kenaikan jumlah CD4+. Perempuan, status bekerja, dan stigma memiliki risiko lebih besar untuk imunodefisiensi. Diperlukan evaluasi pada responden patuh minum ARV tetapi tidak mengalami kenaikan CD4+. Kata kunci : CD4+, faktor memengaruhi kepatuhan, terapi ARV, HIV/AIDS, Jayapura