Adherence to antiretroviral therapy among people living with HIV/AIDS in northeastern Brazil

a cross-sectional study

Autores

Palavras-chave:

HIV, Antiretroviral therapy, highly active, Epidemiology, Brazil, Pharmacology

Resumo

BACKGROUND: Nonadherence to antiretroviral therapy (ART) may lead to viral replication and develop-ment of antiretroviral resistance. OBJECTIVE: To identify the factors associated with nonadherence to ART among people living with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). DESIGN AND SETTING: Cross-sectional study in a tertiary-level hospital in northeastern Brazil. METHODS: Intake of less than 90% of the antiretroviral drugs prescribed in the last week prior to the interview was defined as nonadherence. Intake was evaluated using a questionnaire. Descriptive and mul-tivariate analyses were conducted on the study population, with estimation of the respective odds ratios and 95% confidence intervals. RESULTS: The prevalence of nonadherence was 28.4%. Significant associations were found regarding the following variables: age less than 35 years, smoking, sedentary lifestyle, lack of medication and lack of knowledge regarding the patient’s HIV status, on the part of the patient’s partner or family. CONCLUSIONS: Encouragement of adherence to antiretroviral therapy is one of the fundamental pillars of treatment for HIV-infected patients. The high proportion of nonadherence (28.4%) and the predictive factors related to this indicate that it is necessary to improve patients’ adherence to antiretroviral therapy.

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Biografia do Autor

Rita de Cassia Albuquerque Soares, Universidade Federal de Pernambuco

MSc. Doctoral Student, Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil.

Ana Maria de Brito, Fundação Oswaldo Cruz

PhD. Researcher, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ), Recife (PE), Brazil.

Kledoaldo Lima, Universidade Federal de Pernambuco

PhD. Laboratory Analyst (Biomedicine), Hospital das Clínicas (HC), Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil.

Tiago Maria Lapa, Fundação Oswaldo Cruz

PhD. Researcher, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz (FIOCRUZ), Recife (PE), Brazil.

Referências

Bonolo PF, Gomes RRFM, Guimarães MDC. Adesão à terapia anti-retroviral (HIV/aids): fatores associados e medidas da adesão [Adherence to antiretroviral therapy (HIV/AIDS): factors associated and adherence strategies]. Epidemiol Serv Saúde. 2007;16(4):261-78. doi: 10.5123/ S1679-49742007000400005.

Reiners AAO, Azevedo RCS, Vieira MA, Arruda ALG de. Produção bibliográfica sobre adesão/não-adesão de pessoas ao tratamento de saúde [Bibliographic production about adherence/non-adherence to therapy]. Ciênc Saúde Coletiva. 2008;13(Suppl 2):2299-306. doi: 10.1590/S1413-81232008000900034.

World Health Organization (WHO). Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization; 2003. Available from: https://apps.who.int/iris/bitstream/handle/10665/42682/9241545992.pdf;jsessionid=C5E739EC39B83860C7D123173863F586?sequence=1. Accessed in 2019 (Nov 21).

Roberts KJ. Barriers to and facilitators of HIV-positive patients’ adherence to antiretroviral treatment regimens. AIDS Patient Care STDS. 2000;14(3):155-68. PMID: 10763545; doi: 10.1089/108729100317948.

Brito AM, Szwarcwald CL, Castilho EA. Fatores associados à interrupção de tratamento anti-retroviral em adultos com AIDS. Rio Grande do Norte, Brasil, 1999-2002 [Cofactors of antiretroviral treatment interruption in cases of adults with AIDS. Rio Grande do Norte, Brazil, 1999-2002]. Rev Assoc Med Bras. 2006;52(2):86-92. doi: 10.1590/S0104-42302006000200017.

Silva JA, Dourado I, Brito AM, Silva CA. 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; doi: 10.1590/0102-311X00106914.

Hanif H, Bastos FI, Malta M, et al. Individual and contextual factors of influence on adherence to antiretrovirals among people attending public clinics in Rio de Janeiro, Brazil. BMC Public Health. 2013;13:574. PMID: 23758780; doi: 10.1186/1471-2458-13-574.

Miyada S, Garbin AJI, Gatto RCJ, Garbin CAS. Treatment adherence in patients living with HIV/AIDS assisted at a specialized facility in Brazil. Rev Soc Bras Med Trop. 2017;50(5):607-12. PMID: 29160506; doi: 10.1590/0037-8682-0266-2017.

Silveira MP, Guttier MC, Moreira LB, Mirzazadeh A, Page K. Predictors of non-adherence to clinical follow-up among patients participating in a randomized trial of pharmaceutical care intervention in HIV-positive adults in Southern Brazil. AIDS Behav. 2014;18 Suppl 1:S85-8. PMID: 23955660; doi: 10.1007/s10461-013-0591-0.

Costa JM, Torres TS, Coelho LE, Luz PM. Adherence to antiretroviral therapy for HIV/AIDS in Latin America and the Caribbean: Systematic review and meta-analysis. J Int AIDS Soc. 2018;21(1). PMID: 29356390; doi: 10.1002/jia2.25066.

Rocha GM, Machado CJ, Acurcio F de A, Guimarães MD. Monitoring adherence to antiretroviral treatment in Brazil: an urgent challenge. Cad Saúde Pública. 2011;27 Suppl 1:S67-78. PMID: 21503526; doi: 10.1590/ S0102-311X2011001300008.

Malta M, Petersen ML, Clair S, Freitas F, Bastos FI. Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil. Cad. Saúde Pública. 2005;21(5):142432. PMID: 16158148; doi: /S0102-311X2005000500015.

Pinheiro CA, Mattos Souza LD, Motta JV, et al. Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals. Braz J Infect Dis. 2016;20(6):599-604. PMID: 27789283; doi: 10.1016/j.bjid.2016.09.006.

Batista Jd, Albuquerque M de F, Santos ML, et al. Association between smoking, crack cocaine abuse and the discontinuation of combination antiretroviral therapy in Recife, Pernambuco, Brazil. Rev Inst Med Trop Sao Paulo. 2014;56(2):127-32. PMID: 24626414; doi: 10.1590/S0036-46652014000200007.

Silva JA, Dourado I, Britto AM, Silva CA. 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 Saúde Pública. 2015;31(6):1188-98. PMID: 26200367; doi: 10.1590/0102-311X00106914.

de Fatima Bonolo P, Ceccato Md, Rocha GM, et al. Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy. Clinics (Sao Paulo). 2013;68(5):612-20. PMID: 23778401; doi: 10.6061/clinics/2013(05)06.

Tufano CS, Amaral RA, Cardoso LR, Malbergier A. The influence of depressive symptoms and substance use on adherence to antiretroviral therapy. A cross-sectional prevalence study. Sao Paulo Med J. 2015;133(3):179-86. PMID: 25250800; doi: 10.1590/1516-3180.2013.7450010.

Li H, Marley G, Ma W, et al. The Role of ARV Associated Adverse Drug Reactions in Influencing Adherence Among HIV-Infected Individuals: A Systematic Review and Qualitative Meta-Synthesis. AIDS Behav. 2017;21(2):341-51. PMID: 27613645; doi: 10.1007/s10461-016-1545-0.

Li P, Liao L, Xu W, et al. Adherence, virological outcome, and drug resistance in Chinese HIV patients receiving first-line antiretroviral therapy from 2011 to 2015. Medicine (Baltimore). 2018;97(50):e13555. PMID: 30558015; doi: 10.1097/MD.0000000000013555.

Secretaria de Vigilância em Saúde. Departamento de DST, Aids e Hepatites Virais. Protocolo de assistência farmacêutica em DST/HIV/Aids: Recomendações do Grupo de Trabalho de Assistência Farmacêutica. Brasília, DF: Ministério da Saúde; 2010. 224 p.

Wachholz NIR, Ferreira J. Adesão aos anti-retrovirais em crianças: um estudo da prevalência e fatores associados [Adherence to antiretroviral therapy in children: a study of prevalence and associated factors]. Cad Saúde Pública. 2007;23 Suppl. 3:S424-34. doi: 10.1590/S0102-311X2007001500010.

Carvalho CV, Duarte DB, Merchán-Hamann E, Bicudo E, Laguardia J. Determinantes da aderência à terapia anti-retroviral combinada em Brasília, Distrito Federal, Brasil, 1999-2000 [Predictors of compliance with highly active antiretroviral therapy in Brasilia, Distrito Federal, Brazil, 1999-2000]. Cad Saúde Pública. 2003;19(2):593-604. doi: 10.1590/ S0102-311X2003000200026.

Webb MS, Vanable PA, Carey MP, Blair DC. Medication adherence in HIV-infected smokers: the mediating role of depressive symptoms. AIDS Educ Prev. 2009;21(3 Suppl):94-105. PMID: 19537957; doi: 10.1521/ aeap.2009.31.3_supp.94.

Colombrini MRC, Dela Coleta MF, Lopes MHBM. Fatores de risco para a não adesão ao tratamento com terapia antiretroviral altamente eficaz [Risk factors for non-compliance to treatment with highly effective antiretroviral therapy]. Rev Esc Enferm USP. 2008;42(3):490-5. doi: 10.1590/S0080-62342008000300011.

Mehta S, Moore RD, Graham NM. Potential factors affecting adherence with HIV therapy. AIDS. 1997;11(14):1665-70. PMID: 9386800.

Nixon S, O’Brien K, Glazier RH, Tynan AM. Aerobic exercise interventions for adults living with HIV/AIDS. Cochrane Database Syst Rev (Online). 2005;18(2):CD001796. PMID: 15846623; doi: 10.1002/14651858. CD001796.pub2.

Moraes RP, Casseb J. Depression and adherence to antiretroviral treatment in HIV-positive men in São Paulo, the largest city in South America: Social and psychological implications. Clinics (Sao Paulo). 2017;72(12):743-9. PMID: 29319720; doi: 10.6061/clinics/2017(12)05.

Teixeira PR, Paiva V, Shimma E. Tá difícil de engolir? Experiências de adesão ao tratamento anti-retroviral em São Paulo. São Paulo: Nepaids; 2000.

Seidl EMF, Melchíades A, Faria V, Brito A. Pessoas vivendo com HIV/AIDS: variáveis associadas à adesão ao tratamento anti-retroviral [Persons living with HIV/AIDS: factors associated with adherence to antiretroviral treatment]. Cad Saúde Pública. 2007;23(10):2305-16. doi: 10.1590/ S0102-311X2007001000006.

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Publicado

2019-12-05

Como Citar

1.
Soares R de CA, Brito AM de, Lima K, Lapa TM. Adherence to antiretroviral therapy among people living with HIV/AIDS in northeastern Brazil: a cross-sectional study. Sao Paulo Med J [Internet]. 5º de dezembro de 2019 [citado 29º de abril de 2025];137(6):479-85. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/994

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