Introduction: The acquired immunodeficiency syndrome remains a health challenge in Brazil. Therapeutic failures, characterized by detectable viral load, must have their causes evaluated. Among the most relevant reasons is the lack of adherence to treatment. Objective: To evaluate factors associated with inadequate control of viral load in individuals with HIV in the CAP of Itajubá (MG). Methods: This is an observational, cross-sectional and documentary study with 261 medical records. The variables analyzed were gender, age, education, residence, sexual orientation, first and last test results of tests for viral load and CD4+ T lymphocytes, history of poor adherence, use of current antiretroviral therapy (ART), duration of ART use, depression and/or anxiety, use of illicit drugs, follow-up time at the CAP. Results: Of the patients, 90.42% had an undetectable viral load and 64.37% had a CD4+ T count ≥500 in the last available test. Some characteristics were related to detectable viral load in the last exam: history of poor adherence during treatment (p<0,0001), inconsistent use of ART (p<0,0001) and use of illicit drugs (p=0,0155). Anxiety and/or depression was not statistically significant (p=0,3321). Conclusion: History of poor adherence, inconsistent use of ART and use of illicit drugs were associated with an increased risk ok virological failure. The identification of groups at risk of poor adherence to treatment can support the development of intervention strategies in an early and transdisciplinary way to improve adherence and generate better results in the control of HIV infection.
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