Análise de indicadores clínicos e sociais de má adesão à terapia antirretroviral em pacientes vivendo com HIV/aids

Abstract

Brazil stands out among developing countries with regard to the treatment of HIV infection. According to Ministry of Health data, in 2018 about 60% of people living with HIV received antiretroviral medication in the country (11). This is quite significant considering that overall the percentage of coverage with these medications is around 46%. ARV therapy is essential for the control of replication of the HIV virus and the consequent recovery or prevention of depletion of cellular immunity. However, the irregular use of these medications promotes the selection of resistant viral variants, which leads to treatment failure and clinical deterioration. In this way, promoting adherence is a priority activity of health teams that deal with people living with HIV. In this context, the present study aimed to evaluate factors related to poor adherence to ARV therapy among people living with HIV / AIDS in a referral center located in the city of Sertãozinho-SP. The study was of the Transversal type, where a sample of 143 patients from the total follow-up by the outpatient clinic was selected, and by means of questionnaire and chart analysis it was possible to determine the presence of poor adherence to the ARV treatment, which was defined in 25,87%. All included cases underwent a baseline evaluation for specific data collection, through an informed consent term. The analysis of the results was made by comparing the prevalences between two groups, known as "poor adherence" and "undetectable", defined for the purpose of this study, by quantifying viral load (VL = 40 copies / ml blood). In view of the results presented, it was possible to trace an epidemiological profile of the patients assisted by the Sertãozinho outpatient clinic and to define which clinical and social factors may be related to the poor adherence to the treatment. The study evidenced the prevalence of socioeconomic factors and frequency of alcohol use, as predictors for poor adherence, as well as the need to discuss strategies of adherence in a broad sense with the network, besides having guided the elaboration of proposals for improvements in the structure of the outpatient clinic for the implementation of new care routines, as a strategy to favor patients' adherence to ART.