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      ADESÃO À TERAPIA ANTIRRETROVIRAL EM ADULTOS COM HIV/AIDS ATENDIDOS EM UM SERVIÇO DE REFERÊNCIA Translated title: ADHESIÓN A LA TERAPIA ANTIRRETROVIRAL EN ADULTOS CON VIH/SIDA ATENDIDOS EN UN SERVICIO DE REFERENCIA Translated title: ADHERENCE TO ANTIRETROVIRAL THERAPY IN ADULTS WITH HIV/AIDS TREATED AT A REFERENCE SERVICE

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          Abstract

          RESUMO Objetivo: identificar a adesão à terapia antirretroviral de adultos com HIV/AIDS e os fatores associados a esse comportamento. Método: estudo transversal com 172 pessoas com HIV/AIDS, em que foram utilizados os questionários para avaliação da adesão ao tratamento antirretroviral e identificação dos aspectos sociodemográficos e comportamentais. Os dados foram analisados por meio das estatísticas descritiva e inferencial. Resultados: houve predomínio de homens (57,6%), com idade média de 43,4 (± 11,8 anos), solteiros (38,9%), primeiro grau incompleto (57,1%), sem trabalho remunerado (66,9%) e heterossexuais (87,8%). Adesão baixa/insuficiente prevaleceu (62,2%). Foram observadas associações significativas com o sexo (p=0,0026), escolaridade (p=0,0094) e forma de transmissão do HIV (p=0,0283). Constatou-se maior chance de homens e dos participantes com ensino médio incompleto de adesão baixa/insuficiente. Conclusão: a adesão ao tratamento das pessoas com HIV/AIDS é baixa/insuficiente e associa-se a fatores sociodemográficos e comportamentais.

          Translated abstract

          RESUMEN Objetivo: identificar la adhesión a la terapia antirretroviral de adultos con VIH / Sida y los factores asociados a este comportamiento. Método: estudio transversal con 172 personas con VIH /Sida en el cual se utilizaron cuestionarios para evaluar la adhesión al tratamiento antirretroviral e identificar los aspectos sociodemográficos y comportamentales. Los datos se analizaron a través de las estadísticas descriptiva e inferencial. Resultados: hubo predominio de hombres (57,6%), con edad media de 43,4 (± 11,8 años), solteros (38,9%), escolaridad primaria incompleta (57,1%), sin trabajo remunerado ( 66,9%) y heterosexuales (87,8%). Prevaleció la adhesión baja / insuficiente (62,2%). Se observaron asociaciones significativas con el sexo (p = 0.0026), escolaridad (p = 0.0094) y forma de transmisión del VIH (p = 0.0283). Se constató una mayor probabilidad de hombres y de participantes con escolaridad secundaria incompleta de adhesión baja / insuficiente. Conclusión: la adhesión al tratamiento de las personas con VIH/sida es baja / insuficiente y está asociada con factores sociodemográficos y comportamentales.

          Translated abstract

          ABSTRACT Objective: to identify the adherence to antiretroviral therapy in adults with HIV / AIDS and the factors associated with this behavior. Method: a cross-sectional study with 172 people with HIV / AIDS, in which questionnaires were used to assess adherence to antiretroviral treatment and to identify sociodemographic and behavioral aspects. Data were analyzed using descriptive and inferential statistics. Results: there was a prevalence of men (57.6%), with a mean age of 43.4 (± 11.8 years), single (38.9%), incomplete primary school education (57.1%), and without paid work (66.9%) and heterosexual (87.8%). A low / insufficient adherence prevailed (62.2%). Significant associations with gender (p = 0.0026), schooling (p = 0.0094) and forms of HIV transmission (p = 0.0283) were observed. There was a greater chance of men and participants with incomplete secondary level education with low / insufficient adherence. Conclusion: treatment adherence in people with HIV/AIDS is low/inadequate and associated with sociodemographic and behavioral factors.

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          Most cited references21

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          Valoración de la adhesión al tratamiento antirretroviral en pacientes VIH+

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            Hazardous and harmful use of alcohol and/or other drugs and health status among South African patients attending HIV clinics.

            There is growing recognition of the influence of substance use, particularly alcohol use, on HIV disease progression. This study investigated how hazardous/harmful use of alcohol and drugs impacts the health status of 1503 patients attending HIV clinics. Of the sample, 37 % indicated hazardous/harmful drinking and 13 % indicated a drug problem. Hazardous/harmful use of alcohol and drugs was significantly related to health status, with participants using substances more likely to have TB-positive status (χ(2) = 4.30, p < 0.05), less likely to be on ARVs (χ(2) = 9.87, p < 0.05) and having lower CD4 counts (t = 4.01, p < 0.05). Structural equation modelling confirmed the centrality of hazardous/harmful use of alcohol as a direct and indirect determinant of disease progression. Based on these findings it is recommended that patients attending HIV clinics be routinely screened for problematic alcohol and/or drug use, with strong emphasis on ensuring ARV adherence in those with problematic alcohol use.
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              The HIV-Brazil Cohort Study: Design, Methods and Participant Characteristics

              Background The HIV-Brazil Cohort Study was established to analyze the effectiveness of combination antiretroviral therapy (cART) and the impact of this treatment on morbidity, quality of life (QOL) and mortality. The study design, patients’ profiles and characteristics of cART initiation between 2003 and 2010 were described. Methodology/Principal Findings Since 2003, the HIV-Brazil Cohort has been following HIV-infected adults receiving cART at 26 public health care facilities, using routine clinical care data and self-reported QOL questionnaires. When not otherwise available, data are obtained from national information systems. The main outcomes of interest are diseases related or unrelated to HIV; suppression of viral replication; adverse events; virological, clinical and immunological failures; changes in the cART; and mortality. For the 5,061 patients who started cART between 2003 and 2010, the median follow-up time was 4.1 years (IQR 2.2–5.9 years) with an 83.4% retention rate. Patient profiles were characterized by a predominance of men (male/female ratio 1.7∶1), with a mean age of 36.9 years (SD 9.9 years); 55.2% had been infected with HIV via heterosexual contact. The majority of patients (53.4%) initiated cART with a CD4+ T-cell count ≤200 cells/mm3. The medications most often used in the various treatment regimens were efavirenz (59.7%) and lopinavir/ritonavir (18.2%). The proportion of individuals achieving viral suppression within the first 12 months of cART use was 77.4% (95% CI 76.1–78.6). Nearly half (45.4%) of the patients presented HIV-related clinical manifestations after starting cART, and the AIDS mortality rate was 13.9 per 1,000 person-years. Conclusions/Significance Results from cART use in the daily practice of health services remain relatively unknown in low- and middle-income countries, and studies with the characteristics of the HIV-Brazil Cohort contribute to minimizing these shortcomings, given its scope and patient profile, which is similar to that of the AIDS epidemic in the country.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                reme
                Reme: Revista Mineira de Enfermagem
                Reme : Rev. Min. Enferm.
                Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil )
                1415-2762
                2316-9389
                October 2018
                : 22
                : 0
                : e-1127
                Affiliations
                [1] Florianópolis SC orgnameHospital Universitário Professor Polydoro Ernani de São Thiago Brazil
                [3] Florianópolis SC orgnameUFSC orgdiv1Curso de Enfermagem Brazil
                [2] Florianópolis Santa Catarina orgnameUniversidade Federal de Santa Catarina Brazil
                Article
                S1415-27622018000100251
                10.5935/1415-2762.20180050
                9899d412-3c8a-438d-995b-2b02b7607a22

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 22 May 2017
                : 11 June 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 0
                Product

                SciELO Revista de Enfermagem


                Adultos,HIV,Adult,Medication Adherence,Adulto,Adesão à Medicação,VIH,Cumplimiento de la Medicación

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