Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil

Abstract

Introduction:In the 1990s, Brazil adopted a public policy that allowed for universal, free access to antiretroviral therapy (ART). Since then, treatment adherence has become a new challenge for administrators of sexually transmitted disease/acquired immunodeficiency syndrome (STD/AIDS) policies. This study quantified adherence to ART and verified whether there is an association between sociodemographic variables and clinical/laboratory data in human immunodeficiency virus (HIV)-infected patients. Methods: This was a cross-sectional, exploratory study with a quantitative approach that was conducted over 8 months.The target population contained patients who were assisted at the ambulatory care facility specialized in STD/AIDS of a mediumsize city located in Northwest São Paulo. In order to verify the level of adherence to ART, a validated CEAT-VIH (Assessment of Adherence to Antiretroviral Therapy Questionnaire) questionnaire was used. Sociodemographic aspects and clinical/laboratory data were obtained from the medical records. The results were analyzed using the Student's t-test and Pearson's coefficient. Results: Herein, 109 patients were interviewed, 56% of whom were male. The age of the population ranged 18-74 years (mean 45.67 years). Adherence to ART was classified as insufficient in 80.7% of cases. There was an association between ART adherence and presence of symptoms and/or opportunistic infection (p=0.008) and economic status (p<0.001). Conclusions: Adherence to ART among HIV carriers cared for by the public health system is low. Patients who reported a favorable economic status and those without symptoms and/or opportunistic infection demonstrated greater treatment adherence than those who needed to take more than 3 pills a day.

Adherence to antiretroviral therapy among people living with HIV/AIDS in northeastern Brazil: a cross-sectional study

“…4 The ART adherence rates in Brazil vary from 20% to 84%. [5][6][7][8][9] However, the way in which this adherence to therapy is measured differs between studies. In a meta-analysis on ART adherence rates in Latin American and Caribbean countries, Costa et al 10 found that they varied according to the length of time over which the measurement was made.…”

“…Pinheiro et al 13 found that elderly patients had a higher adherence rate and, consequently, that a higher proportion of these patients had an undetectable viral load. Additionally, nonadherence has been correlated with use of illicit drugs, 14,15 smoking, 14,16 alcohol consumption, 16 depressive symptoms, 17 lower schooling levels and economic status, 8,15 adverse reactions, 18 symptoms of opportunistic diseases 8 and longer time between infection and receiving the diagnosis of HIV and starting treatment. 15 Interruption or irregularity of use of antiretroviral drugs is a public health problem in the fight against the HIV epidemic.…”

Analysis of compliance to antiretroviral treatment among patients with HIV/AIDS

“…Likewise, treatment compliance seems to be determined by a number of factors such as morbidities, number of pills per day, chronic and infectious conditions, environmental factors, structural and personal factors, educational level and income (13)(14) . According to Silva et al (3) , a higher level of education can be related to a better understanding of the pathology and of the drug therapy, contributing to a greater compliance to treatment, which was also observed in the study by Myiada et al (14) . On the other hand, a low level of education has been related to a change in the profile of the patient, presenting an association not only with treatment compliance but also with virus infection itself (3,15) .…”

HIV infected patients attendance in a Brazilian public health service: A short report

“…In M2, six individuals were graduated. Although this 101 fact contradicts the growing rates tendency of HIV infection in populations with less years of 102 education (Miyada et al, 2017), additional years of study could be a factor that has led the 31 103 patients to continually care for their health, however this statement requires better evaluation. 104…”