Fatores Associados à não Adesão ao Tratamento Antirretroviral em Adultos acima de 50 Anos que Têm HIV/Aids

Abstract

Introduction: drug technology implied on morbidity and mortality reduction of people who have HIV/aids. Levels of adherence to antiretroviral use influences on treatment's success or not. Adherence is considered as the biggest determinant as therapeutic response, however there's not a standard method established for its evaluation. Objective: to identify factors associated to the non-adherence to antiretroviral treatment in adults above 50 years old who have aids. Method: cross-sectional design with a population of 72 patients. Data collection was developed, after ethics committee approval, with structured interview, from April/2009 to October/2010. It was developed bi-varied analysis, crossing the result (adherence to ARVT) with behavioral varies of non-adherence classifications. Results: non-adherence prevalence was of 29,2%. Factors associated to non-adherence were: knowledge about viral load and treatment motive; alcoholic beverage; side effects; coincidence between work time and time to ingest any medicine dose; assistance time in the Service; frequency to consults; and necessity of someone that takes one to the Service. Conclusion: these factors imply on patient's health and it's going to be associated on caring for oneself, in order to minimize illness possibilities, and caring for the other, referring to infection transmission potential on collective level.

Diagnósticos de enfermagem e seus componentes em pacientes com a síndrome da imunodeficiência adquirida

“…(25) It is further noted that the feeling of shame or fear of suffering from prejudice from friends and families when they become aware of the illness can contribute to the non-use of antiretroviral drugs in public places or at work, which can have an influence in treatment efficacy. (25) Drug use can interfere in noncompliance to treatment, due to behavioral and cognitive changes on the individual's state of mind, making them forget to take the medications. Furthermore, serum levels of blood alcohol can increase the antiretroviral therapy side effects, which can lead the patient to opt for interrupting the drug therapy.…”

“…(26) Studies show that the onset of side effects, particularly at the beginning or during the change of antiretroviral therapy, manifests as one of the troublesome factors that lead to the withdrawal or interruption of the treatment. (15,25) It is noteworthy that the development of renal, hepatic, neurologic, cardiovascular complications and malignancies can be linked to treatment withdrawal or irregularity. This is due to the fact that the antiretroviral therapy plays an important role in sues, explaining that the disease, the medications, and stress often alter the sexual function, encouraging them to verbalize and make questions, and trying to include the sexual partner, whenever appropriate.…”

“…(3) Behaviors indicating noncompliance and failure in keeping scheduled appointments are evidenced by the patient withdrawal or interruption of the use of antiretroviral drugs and not showing up at the health services, to receive medications, to attend to medical appointments, or to make exams. (25) Negative convictions related to the illness or treatment, lack of motivation feelings or denial of health condition expressed by the individual, resistance or difficulty changing behaviors and lifestyle habits are part of the fundamental values of the individual that hinder adherence to the treatment of the illness. (25) It is further noted that the feeling of shame or fear of suffering from prejudice from friends and families when they become aware of the illness can contribute to the non-use of antiretroviral drugs in public places or at work, which can have an influence in treatment efficacy.…”

“…(25) Negative convictions related to the illness or treatment, lack of motivation feelings or denial of health condition expressed by the individual, resistance or difficulty changing behaviors and lifestyle habits are part of the fundamental values of the individual that hinder adherence to the treatment of the illness. (25) It is further noted that the feeling of shame or fear of suffering from prejudice from friends and families when they become aware of the illness can contribute to the non-use of antiretroviral drugs in public places or at work, which can have an influence in treatment efficacy. (25) Drug use can interfere in noncompliance to treatment, due to behavioral and cognitive changes on the individual's state of mind, making them forget to take the medications.…”

“…Furthermore, serum levels of blood alcohol can increase the antiretroviral therapy side effects, which can lead the patient to opt for interrupting the drug therapy. (25) Additionally, forgetfulness can also be the result of a depressive condition, which adds up to memory and attention deficit. (26) Studies show that the onset of side effects, particularly at the beginning or during the change of antiretroviral therapy, manifests as one of the troublesome factors that lead to the withdrawal or interruption of the treatment.…”