Adherence to antiretroviral therapy among women living with HIV/AIDS in the interior of the Brazilian state of Pará
cross-sectional study
Keywords:
HIV, Acquired immunodeficiency syndrome, Therapeutics, Anti-retroviral agents, Women’s healthAbstract
BACKGROUND: High prevalence of human immunodeficiency virus (HIV) infection and occurrence of drug-resistant strains have been recorded in northern Brazil. Abandonment of treatment and insufficient and inadequate adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been recorded in the metropolitan area of Belém, the capital of the state of Pará. OBJECTIVES: To identify the sociodemographic profile and level of adherence to ART among women seen at a referral unit in the interior of Pará, northern Brazil. DESIGN AND SETTING: Cross-sectional study at a referral unit for care for PLWHA. METHODS: We included 86 women living with HIV/AIDS (WLWHA) in the Rio Caeté integrated region, northeastern Pará. Social, demographic and behavioral information, as well as the ART level, were obtained using forms that have been described in the scientific literature. Logistic regression models were used to assess associations of variables with ART. RESULTS: Most WLWHA were single (52.4%), young (47.7%) and heterosexual (97.7%), had low levels of education (63.0%), were unemployed (69.8%), had one sexual partner (75.7%), used condoms (46.7%) and were not using either licit drugs (68.7%) or illicit drugs (89.6%). Their adherence level was classified as insufficient , and only their viral load showed an association with ART. CONCLUSIONS: The participants’ low level of education and poor socioeconomic conditions may have been interfering with their adherence to ART. Such influences can be minimized through multiprofessional interventions that take the individuality of women served by the healthcare service into consideration.
Downloads
References
Galvão JMV, da Costa ACM, Galvão JV. Perfil sócio demográfico de portadores de HIV/AIDS de um serviço de atendimento especializado. Rev Enferm UFPI. 2017;6(1):4-8.
Brasil, Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim Epidemiológico HIV/AIDS 2018. Available from: Available from: http://www.aids.gov.br/pt-br/pub/2018/boletim-epidemiologico-hivaids-2018 Accessed in 2020 (Sep 23).
Faqueti A, Rodriguez AMM, Woerner CB, Antonio GD. Perfil epidemiológico de mortalidade por AIDS na população adulta do Brasil de 2001 a 2010. Revista Saúde Pública de Santa Catarina. 2014;2(7):29-39. Available from: Available from: http://revista.saude.sc.gov.br/index.php/inicio/article/view/239 Accessed in 2020 (Sep 23).
Villela WV, Barbosa RM. Trajetórias de mulheres vivendo com HIV/AIDS no Brasil, avanços e permanências da resposta à epidemia [Trajectories of women living with HIV/AIDS in Brazil. Progress and permanence of the response to the epidemic]. Cien Saude Colet. 2017;22(1):87-96. PMID: 28076532; https://doi.org/10.1590/1413-81232017221.14222016.
Dantas C, Dantas F, Monteiro B, Leite J. Perfil epidemiológico dos pacientes com HIV atendidos em um centro de saúde da região litorânea do estado de Rio de Janeiro, Brasil. 2010-2011 [Epidemiological profile of HIV patients of coastal region of Rio de Janeiro state, Brazil, in 2010-2011]. Arq Catarin Med. 2017;46(1):22-32. Available from: Available from: http://www.acm.org.br/acm/seer/index.php/arquivos/article/view/250/137 Accessed in 2020 (Sep 23).
Schuelter-Trevisol F, Paolla P, Justino AZ, et al. Perfil epidemiológico dos pacientes com HIV atendidos no sul do Estado de Santa Catarina, Brasil. em 2010 [Epidemiological profile of HIV patients in the southern region of Santa Catarina state in 2010]. Epidemiol Serv Saude. 2013;22(1):87-94. https://doi.org/10.5123/S1679-49742013000100009.
Oliveira-Filho AB, Silva FQ, Santos FJA, et al. Prevalence and risk factors for HIV-1 infection in people who use illicit drugs in northern Brazil. Trans R Soc Trop Med Hyg. 2020114(3):213-21. PMID: 31746322; https://doi.org/10.1093/trstmh/trz106.
Irias SDF, Torres MKS, Avelino MES, et al. HIV-1 transmitted drug resistance mutations in recently diagnosed antiretroviral-naive patients in Belém, Pará, northern Brazil. AIDS Res Hum Retroviruses. 2019;35(2):121-2. PMID: 30560686; https://doi.org/10.1089/aid.2018.0169.
da Costa LM, Raiol NC, Lisboa BLA, et al. Prevalence and risk factors for human immunodeficiency virus infection among female sex workers: distinct offers of sexual services in a municipality of the Brazilian Amazon. AIDS Res Hum Retroviruses. 2019;35(9):826-32. PMID: 31204860; https://doi.org/10.1089/aid.2019.0032.
da Costa LM, Frade PCR, Blandtt LDS, et al. HIV-1 genetic diversity and transmitted drug resistance mutations in female sex workers from a Brazilian municipality in the Amazon region. AIDS Res Hum Retroviruses. 2020;36(2):99-100. PMID: 31724429; https://doi.org/10.1089/aid.2019.0243.
Costa DF, Gonçalves ASR, Vieira JRS, Guerreiro JF. Adesão à terapia antirretroviral de pacientes portadores de HIV/Aids com lipodistrofia [Adherence to antiretroviral therapy by HIV/AIDS patients with lipodystrophy]. Rev Enferm UERJ. 2018;26:e31156. https://doi.org/10.12957/reuerj.2018.31156.
Leyro TM, Vujanovic AA, Bonn-Miller MO. Examining associations between cognitive-affective vulnerability and HIV symptom severity. Perceived barriers to treatment adherence. and viral load among HIV-positive adults. Int J Behav Med. 2015;22(1):139-48. PMID: 24643444.; https://doi.org/10.1007/s12529-014-9404-8.
Remor E, Milner-Moskovics J, Preussler G. Brazilian adaptation of the assessment of adherence to antiretroviral therapy questionnaire. Rev Saude Publica. 2007;41(5):685-94. PMID: 17713708; https://doi.org/10.1590/s0034-89102006005000043.
Foresto JS, Melo ES, Costa CRB, et al. Adesão à terapêutica antirretroviral de pessoas vivendo com HIV/AIDS em um município do interior paulista. Rev Gaúcha Enferm. 2017;38(1):e63158. https://doi.org/10.1590/1983-1447.2017.01.63158.
Goulart S, Meirelles BHS, Costa VT, et al. Adherence to antiretroviral therapy in adults with HIV/AIDS treated at a reference service. Rev Min Enferm. 2018;22:e-1127. https://doi.org/10.5935/1415-2762.20180050.
Carvalho PP, Barroso SM, Coelhos HC, Penaforte FRO. Fatores associados à adesão à Terapia Antirretroviral em adultos: revisão integrativa de literatura [Factors associated with antiretroviral therapy adherence in adults: an integrative review of literature]. Cien Saude Colet. 2019;24(7):2543-55. PMID: 31340272; https://doi.org/10.1590/1413-81232018247.22312017.
Secretaria de Estado e Saúde Pública do Pará, Brasil. Plano Estadual de Saúde do Pará (2012 - 2015). Available from: Available from: https://www2.mppa.mp.br/sistemas/gcsubsites/upload/37/PES-2012-2015.pdf Accessed in 2020 (Sep 23).
Instituto Brasileiro de Geografia e Estatística, Brasil. Panorama: Municípios do Pará. Brasil. Available from: Available from: https://cidades.ibge.gov.br/brasil/pa/panorama Accessed in 2020 (Sep 23).
Moraes DCA, Oliveira RC, Motta MCS, Ferreira OLC, Andrade MS. Terapia antirretroviral: a associação entre o conhecimento e a adesão [Antiretroviral therapy: the association between knowledge and the compliance]. Rev Pesq. 2015;7(4):3563-73. Available from: Available from: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1029891 Accessed in 2020 (Sep 20).
Silva LMS, Moura MAV, Pereira MLD. The daily life of women after HIV/AIDS infection: guidelines for nursing care. Texto Contexto - Enferm. 2013;22(2):335-42. https://doi.org/10.1590/S0104-07072013000200009.
Madruga LGSL, Silva GVV, Alves VAR, et al. Aspectos relacionados à utilização de antirretrovirais em pacientes de alta complexidade no estado do Rio de Janeiro, Brasil [Aspects related to the use of antiretrovirals in high complexity patients in the state of Rio de Janeiro]. Cien Saude Colet. 2018;23(11):3649-62. PMID: 30427438; https://doi.org/10.1590/1413-812320182311.24742016.
Santos VF, Galvão MTG, Cunha GH, Lima ICV, Gir E. Efeito do álcool em pessoas com HIV: tratamento e qualidade de vida [Alcohol effect on HIV-positive individuals: treatment and quality of life]. Acta Paul Enferm. 2017;30(1):94-100. doi: 10.1590/1982-0194201700014.
Bertagnoli MSFF, Figueiredo MAC. Gestantes soropositivas ao HIV: maternidade, relações conjugais e ações da psicologia. Psicol Cienc Prof. 2017;37(4):981-94. doi: https://doi.org/10.1590/1982-3703004522016.
Padoin SMM, Züge SS, Aldrighi JD, et al. Mulheres do Sul Brasil em terapia antirretroviral: perfil e o cotidiano medicamentoso. Epidemiol Serv Saúde. 2015;24(1):71-8. https://doi.org/10.5123/S1679-49742015000100008.
Silva JAG, Dourado I, Brito AM, Silva CAL. Factors associated with non-adherence to antiretroviral therapy in adults with AIDS in the first six months of treatment in Salvador, Bahia State, Brazil. Cad Saude Publica. 2015;31(6):1188-98. PMID: 26200367; https://doi.org/10.1590/0102-311X00106914.
Jacques JAA, Santana JM, Moraes DCA, et al. Avaliação da adesão à terapia antirretroviral entre pacientes em atendimento ambulatorial. RBCS. 2015;18(4):303-8. https://doi.org/10.4034/RBCS.2014.18.04.04.
Oliveira LDS, Caixeta LM, Martins JLR, et al. Adherence to antiretroviral therapy and correlation with adverse effects and coinfections in people living with HIV/AIDS in the municipality of Goiás State. Rev Soc Bras Med Trop. 2018;51(4):436-44. PMID: 30133625; https://doi.org/10.1590/0037-8682-0467-2017.
Zuge SS, Primeira MR, Remor E, et al. Fatores associados à adesão ao tratamento antirretroviral em adultos infectados pelo HIV: estudo transversal [Factors associated to the adherence to antiretroviral treatment in HIV-infected adults: cross-sectional study]. Rev Enfermagem UFSM. 2017;7(4):577-89. https://doi.org/10.5902/2179769225657.
Lemos L de A, Fiuza ML, Reis RK, et al. Adherence to antiretrovirals in people coinfected with the human immunodeficiency virus and tuberculosis. Rev Lat Am Enfermagem. 2016;24:e2691. PMID: 27192416; https://doi.org/10.1590/1518-8345.0537.2691.
Salmanton-García J, Herrador Z, Ruiz-Seco P, et al. Self-reported adherence to antiretroviral therapy in HIV+ population from Bata, Equatorial Guinea. AIDS Care. 2015;28(5):543-53. PMID: 26698540; doi: https://doi.org/10.1080/09540121.2015.1124976.
