Adesão à Terapia Antirretroviral de Pessoas Vivendo com HIV/aids

Abstract

Aids cause severe immunodeficiency, associates infections and neoplasms which can lead to death. Due to its pandemic potential and severity, it is considered a global health issue. The antiretroviral therapy (ART) has reduced morbidity and mortality of HIV/aids, which is now recognised as a chronic disease. But the ART benefits are not achieved without treatment adherence.The literature points the value of the investigation at this matter and the need of the health service knows the users profile and them adherence. This way, the main objective in this study was characterize user’s profiles and adherence to TARV in people living with HIV/aids (PLHA) in a country town of the Minas Gerais state. Two measures instruments were used to check the adherence: the validated questionnaire CEAT-VIH and ART pharmacy registry. This objective was divided into two studies. At first, a literature integrative revision guided by a question formulated based on PICO strategy: “What factors identified in the scientific literature are associated with adherence to antiretroviral therapy in adults living with HIV/aids?”. We analyzed 125 articles regarding the studies characteristics, adherence measures and associated factors, published between January 2010 and December 2016. The results showed a major variation to the adherence definition and monitoring measures, besides the several factors related to adherence. Those were categorized as: 1- individual variables, 2- treatment characteristics, 3- HIV/aids infection characteristics, 4- relation with the health service, 5- social support. This study showed the need of continuous adherence monitoring. Then, a 190 participants descriptive study were made to show the users profile characteristics and ART adherence in PLHA at the same country town of the Minas Gerais state. The instruments used were: 1. A questionnaire developed to the research, based on the literature review, that had a focus on sociodemographic, clinical characteristics, life habits, social support, relationship with the health service and knowledge about HIV/aids and ART; 2. Depression, Anxiety and Stress Scale (DASS-21); 3. CEAT-VIH questionnaire, to assess13 adherence; 4. Nutrition data and Antiretroviral Dispensing data questionnaire. Among all participants, 51.6% were male, mean age of 44.9 years (SD: 12.08), low income (64.7%) and low education (57.8%). The mean CD4 count was 596 cells/mm3 (S.D. + 352,28). The majority had 10 years or more of infection (54.2%) and had an undetectable viral load (68.9%). A large proportion (44.4%) had been using ART for more than 10 years. According to the pharmacy registry and CEAT-VIH, 11.1% and 69.0% of respondents were, respectively, considered adherents. Nonadherence high rates were found, indicating the need for health service to know the profile users and continuously monitor adherence to ART treatment to detected early non-adherence and create effective intervention plans.