Há uma tendência mundial de mudanças qualitativas na abordagem clínico-laboratorial do paciente em tratamento para o HIV/aids. A terapia anti-retroviral (TARV) no Brasil, como aconteceu em países industrializados do Hemisfério Norte que adotaram o acesso universal a esse tratamento, trouxe benefícios na sobrevida e redução da morbidade e mortalidade relacionada à doença. O presente artigo teve como objetivo apresentar uma revisão de literatura sobre o tema da adesão à TARV. Encontraram-se 56 artigos com as seguintes variáveis de classificação: fatores sociodemográficos; vulnerabilidade ao HIV; uso dos serviços de saúde; e TARV. A proposição principal extraída dos estudos é a necessidade de monitoramento contínuo dos pacientes. A fase inicial da terapia é crítica e, para criar vínculo com o paciente, é necessário acompanhamento individual, suporte social e informação sobre aids. Os serviços de referências para HIV/aids devem monitorar o início do tratamento no sentido de superar prováveis obstáculos, otimizar as boas experiências e incrementar a adesão aos anti-retrovirais.

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.

Introduction: High level of HIV/AIDS knowledge is required for an effective adoption of preventive strategies. Objective: To assess HIV/AIDS knowledge among men who have sex with men (MSM) in 12 Brazilian cities. Methods: Respondent-Driven Sampling method was used for recruitment. HIV/AIDS knowledge was assessed by Item Response Theory. Difficulty and discrimination parameters were estimated, and the knowledge score was categorized in three levels: high, medium, and low. Logistic regression was used for analysis. Results: Among 4,176 MSM, the proportion of high level of knowledge was 23.7%. The following variables were positively associated with high knowledge (p < 0.05): age 25+ years old, 12+ years of schooling, white skin color, having health insurance, having suffered discrimination due to sexual orientation, having had a syphilis test, and having received educational material in the previous 12 months. Exchanging sex for money was negatively associated. Conclusions: The proportion of only 23.7% of high HIV/AIDS knowledge was low. We should note that the only potential source of knowledge acquisition associated with high level of knowledge was receiving educational materials. Our study indicates the need for expansion of public prevention policies focused on MSM and with more effective communication strategies, including the development of knowledge that involves motivation and abilities for a safer behavior.

The objectives of this study were to evaluate anti-retroviral (ARV) prescription pickups during twelve months following the first prescription and to identify factors associated with irregular pickups or permanent dropout in two public HIV/AIDS referral centers in Belo Horizonte, Minas Gerais State, Brazil. Participants (n = 323) were antiretroviral naïve and were recruited from May 2001 to May 2002. A total of 98 (30.3%) patients abandoned treatment, and 187 (57.9%) had at least one irregular pickup. Patients with irregular pickups and dropouts were compared to those with regular pickups. Multinomial multivariate analysis showed that living outside Belo Horizonte, CD4+ T-lymphocyte count greater than 200/mm(3), and antiretroviral regimen without protease inhibitors were associated with irregular pickups. In addition to these variables, not being on other medications, and any non-adherence recorded on patient charts were associated with treatment dropout. Pharmacy records are important potential indicators of non-adherence and should be incorporated as such in clinical practice. Strategies should be prioritized to reach out to dropouts or patients with irregular ARV pickups.