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ADHERENCE TO ANTIRETROVIRAL THERAPY IN A CONTEXT OF UNIVERSAL ACCESS, IN RIO DE JANEIRO, BRAZIL
Autor(es)
Afiliação
HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University
Department of Health Information, Center for Information in Science and Technology, the Oswald Cruz Foundation
Brazilian Interdisciplinary Association for AIDS, Rio de Janeiro
Brazilian Interdisciplinary Association for AIDS, Rio de Janeiro
HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University
HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York
Department of Health Information, Center for Information in Science and Technology, the Oswald Cruz Foundation
Department of Health Information, Center for Information in Science and Technology, the Oswald Cruz Foundation
Brazilian Interdisciplinary Association for AIDS, Rio de Janeiro
Brazilian Interdisciplinary Association for AIDS, Rio de Janeiro
HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York
Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University
HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute and Columbia University, New York
Department of Health Information, Center for Information in Science and Technology, the Oswald Cruz Foundation
Resumo em Inglês
Adherence is integral to improving and maintaining the health and quality of life of people living with HIV. Two-hundred
HIV-positive adults recruited from teaching hospitals and non-governmental organizations (NGOs) in Rio de Janeiro City
were assessed on socio-demographic factors, adherence to antiretroviral therapy (ART) and psychosocial factors
hypothesized to be associated with ART. Predictors of non-adherence were analyzed using bivariate and multivariate
analyses. Self-reported medication adherence was high (82% had adherence /90%). Non-adherence was associated with
personal factors (i.e. sexual orientation, self-efficacy), physical factors (i.e. loss of appetite) and interpersonal factors (i.e.
doctor-patient relationship). Adherence in Brazil is as good, if not better, than that seen in the US and western Europe,
which is noteworthy since the sample was derived predominantly from public healthcare settings. It is possible that the
connection to NGOs in Rio de Janeiro City played a helpful role in achieving high levels of adherence in this sample of
people living with HIVand AIDS. Recommendations, based on study findings, include enhancing and sustaining supportive
services for NGOs, promoting patient self-efficacy and behavioral skills for adherence, increasing social network support
and having healthcare providers directly address patients’ medication beliefs, attitudes and experience with side effects.
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