Marker events associated with adherence to HIV/AIDS treatment in a cohort study
DOI:
https://doi.org/10.11606/s1518-8787.2023057004219Keywords:
Acquired Immunodeficiency Syndrome, drug therapy, Medication Adherence, Patient Dropouts, Risk Factors, Cohort StudiesAbstract
OBJECTIVE: To analyze how clinical and social events may impact adherence to antiretroviral treatment for HIV. METHODS: This is a historical cohort study with 528 patients who underwent treatment for HIV in a specialized care service in Alvorada, RS. A total of 3429 queries executed between the years 2004 and 2017 were analyzed. For each visit, data on treatment characteristics and the patients' clinical picture were collected. Adherence, as measured by patients' self-report, was the endpoint of the study. The logistic regression model via generalized estimating equations was used for estimating the associations. RESULTS: 67.8% of the patients analyzed have up to 8 years of education and 24.8% have a history of crack and/or cocaine use. Among men, being asymptomatic [odds ratio (OR) = 1.43; 95%CI 1.05-1.93], having more than 8 years of education (OR= 2.32; 95%CI 1.27-4.23), and never having used crack (RC = 2.35; 95%CI 1.20-4.57) were associated with adherence. For women, being older than 24 years (CR = 1.82; 95%CI 1.09-3.02), never having used cocaine (CR = 2.54; 95%CI 1.32-4.88) and being pregnant (RC = 3.28; 95%CI 1.83-5.89) increased the odds of adherence. CONCLUSIONS: In addition to defined sociodemographic characteristics, one-off events that may occur in the trajectory of patients on long treatment, such as starting a new pregnancy and not having symptoms, can impact patients' chances of treatment adherence.
References
Colombrini MRC, Lopes MHBM, Figueiredo RM. Adesão à terapia antiretroviral para HIV/AIDS. Rev Esc Enferm USP. 2006;40(4):576-81. https://doi.org/10.1590/S0080-62342006000400018
Carvalho PP, Barroso SM, Coelho HC, Penaforte FRO. Fatores associados à adesão à terapia antirretroviral em adultos: revisão integrativa de literatura. Cien Saude Colet. 2019;24(7):2543-55. https://doi.org/10.1590/1413-81232018247.22312017
Bonolo PF, Gomes RRFM, Guimarães MDC. Adesão à terapia anti-retroviral (HIV/Aids): fatores associados e medidas da adesão. Epidemiol Serv Saude. 2007;16(4):267-78. https://doi.org/10.5123/S1679-49742007000400005
Leite SN, Vasconcellos MPC. Adesão à terapêutica medicamentosa: elementos para a discussão de conceitos e pressupostos adotados na literatura. Cien Saude Colet. 2003;8(3):775-82. https://doi.org/10.1590/S1413-81232003000300011
Bardeguez AD, Lindsey JC, Shannon M, Tuomala RE, Cohn SE, Smith E, et al. Adherence to antiretrovirals among US women during and after pregnancy. J Acquir Immune Defic Syndr. 2008;48(4):408-17. https://doi.org/10.1097/QAI.0b013e31817bbe80
Ministério da Saúde (BR), Secretaria de Vigilância em Saúde, Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis. Relatório de Monitoramento Clínico do HIV. Brasília, DF; 2019.
Fisch P. Qualificando a cascata do HIV: diferentes tempos até a supressão viral a partir de dados da coorte de Alvorada [tese]. Porto Alegre, RS: Faculdade de Medicina da UFRGS; 2017.
Dunn K, Lafeuille MH, Jiao X, Romdhani H, Emond B, Woodruff K, et al. Risk factors, health care resource utilization, and costs associated with nonadherence to antiretrovirals in medicaid-insured patients with HIV. J Manag Care Pharm. 2018;24(10):1040-51. https://doi.org/10.18553/jmcp.2018.17507
Mukui IN, Ng’ang’a L, Williamson J, Wamicwe JN, Vakil S, Katana A, et al. Rates and predictors of non-adherence to antiretroviral therapy among HIV-positive individuals in Kenya: results from the Second Kenya AIDS Indicator Survey, 2012. PLoS One. 2016;11(12):e0167465. https://doi.org/10.1371/journal.pone.0167465
Colombrini MRC. Fatores preditivos para não-adesão ao tratamento com terapia anti-retroviral altamente eficaz nos casos de HIV/aids [dissertação]. Campinas, SP: Faculdade de Ciências Médicas da UNICAMP; 2003.
Teixeira PR, Paiva V, Shimma E. Tá difícil de engolir? São Paulo: NepAids; 2000.
Faria ER, Carvalho FT, Lopes RS, Piccinini CA, Gonçalves TR, Santos BR. Gestação e HIV: preditores da adesão ao tratamento no contexto do pré-natal. Psicol Teor Pesq. 2014;30(2):197-203. https://doi.org/10.1590/S0102-37722014000200009
Warley EM, Tavella S, Rosas A. Control de embarazo y postparto en mujeres infectadas por HIV. Medicina (B Aires). 2017;77(2):85-8.
Matthews LT, Ribaudo HB, Kaida A, Bennett K, Musinguzi N, Siedner MJ, et al. HIV-infected Ugandan women on antiretroviral therapy maintain HIV-1 RNA suppression across periconception, pregnancy, and postpartum periods. J Acquir Immune Defic Syndr. 2016;71(4):399-406. https://doi.org/10.1097/QAI.0000000000000874
Ministério da Saúde (BR), Secretaria de Vigilância em Saúde, Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis. HIV/Aids 2019. Bol Epidemiol. 2019;Nº Espec:1-17.
Tavares NUL, Bertoldi AD, Mengue SS, Arrais PSD, Luiza VL, Oliveira MA, et al. Factors associated with low adherence to medicine treatment for chronic diseases in Brazil. Rev Saude Publica. 2016;50 Supl 2:10s. https://doi.org/10.1590/S1518-8787.2016050006150
Osterberg L, Blaschke T. Adherence to medication. New Engl J Med. 2005;353(5):487-97. https://doi.org/10.1056/NEJMra050100
Boussari O, Subtil F, Genolini C, Bastard M, Iwaz J, Fonton N, et al. Impact of variability in adherence to HIV antiretroviral therapy on the immunovirological response and mortality. BMC Med Res Methodol. 2015;15:10. https://doi.org/10.1186/1471-2288-15-10
Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133(1):21-30. https://doi.org/10.7326/0003-4819-133-1-200007040-00004
Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74. https://doi.org/10.1097/00005650-198601000-00
Pons ES. Autogestão do uso de medicamentos pela população brasileira [tese]. Porto Alegre, RS: Faculdade de Medicina da UFRGS; 2016.
Alencar TMD. A vida crônica é novidade na Aids: as transformações da Aids aguda para a Aids crônica sob o ponto de vista dos pacientes [dissertação]. São Paulo: Faculdade de Medicina da USP; 2006.
Schaurich D, Coelho DF, Motta MGC. A cronicidade no processo saúde-doença: repensando a epidemia da Aids após os anti-retrovirais. Rev Enferm UERJ. 2006;14(3):455-62.
Gonzalez A, Barinas J, O’Cleirigh C. Substance use: impact on adherence and HIV medical treatment. Curr HIV/AIDS Rep. 2011;8(4):223-34. https://doi.org/10.1007/s11904-011-0093-5
Hayashi K, Wood E, Kerr T, Dong H, Nguyen P, Puskas CM, et al. Factors associated with optimal pharmacy refill adherence for antiretroviral medications and plasma HIV RNA non-detectability among HIV-positive crack cocaine users: a prospective cohort study. BMC Infect Dis. 2016;16(1):455. https://doi.org/10.1186/s12879-016-1749-y
Wechsberg WM, Horst C, Ndirangu J, Doherty IA, Kline T, Browne FA, et al. Seek, test, treat: substance-using women in the HIV treatment cascade in South Africa. Addict Sci Clin Pract. 2017;12(1):12. https://doi.org/10.1186/s13722-017-0077-x
Instituto Brasileiro de Geografia e Estatística. IBGE Cidades. Rio de Janeiro: IBGE; c2010 [citado 7 dez 2019]. Disponível em: https://cidades.ibge.gov.br/
Programa das Nações Unidas para o Desenvolvimento (PNUD); Instituto de Pesquisa Econômica Aplicada (Ipea); Fundação João Pinheiro. Atlas do Desenvolvimento Humano do Brasil: Alvorada, RS. Brasília, DF; c2013 [citado 11 dez 2019]. Disponível em: http://www.atlasbrasil.org.br/ranking
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Copyright (c) 2023 Rafael Steffens Martins, Daniela Riva Knauth, Alvaro Vigo, Patrícia Fisch
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