Factors associated with adherence to antiretroviral therapy in HIV-infected subjects and the use of indicators to characterize the treatment adhesion profile

Abstract

At present, there is no gold standard to assess patient adherence to combination antiretroviral therapy (cART). Therefore, this study aimed to characterize the epidemiological profile, delineate adherence indicators, and identify factors associated with adherence and delays in obtaining medication in patients registered at the Specialized Assistance Service in HIV/AIDS in Brazil. This is a descriptive study based on secondary data obtained from official databases of the Brazilian Ministry of Health. Adherence and delay were measured by the frequency of cART medication acquisition in 24 months, and a multivariate linear regression model was developed to identify the factors associated with non-adherence and delays. In 50.2% of the subjects, the viral load remained undetectable throughout the study period. Only 12.4% of patients were fully adherent to cART. Regarding indicators, a value of 0.83 was found for adherence, 0.09 for delay in days, and 0.21 for the number of times the patient was late to obtain the medication. The multivariate analysis showed that males, age between 20 and 59 years, having not changed the cART, and the presence of X1000 HIV RNA copies/mL were predictive factors for adherence and delays (Pp0.01). We demonstrated that monitoring cART medication distribution is possible using health indicators, and identifying the factors associated with poor adherence to cART helps characterize patients at higher risks of unsuccessful therapy.

Detectable Virological Load and Associated Factors among People Living with HIV on Antiretroviral Treatment: A Retrospective Study

“…Several methods have been used in clinical trials, including patient self-assessment, data provided by the pharmacy, electronic system for monitoring therapeutic events, and blood monitoring of drugs. However, each of these methods may present critical issues [43][44][45]. Among the different methodologies for measuring adherence to therapy, we used an approach based on a doctor's perception during follow-up visits.…”

“…Adherence to medication may also be influenced by other factors, such as the relationship with the doctor, ease of access to healthcare services and information, clinical and laboratory follow-up, and treatment success [43]. Therefore, monitoring patients' adherence to therapy and taking appropriate measures to improve it are key actions to ensure an adequate response to treatment.…”