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. 2023 Apr 14:57:20.
doi: 10.11606/s1518-8787.2023057004219. eCollection 2023.

Marker events associated with adherence to HIV/AIDS treatment in a cohort study

[Article in English, Portuguese]
Rafael Steffens Martins  1 , Daniela Riva Knauth  2 , Alvaro Vigo  3 , Patrícia Fisch  1
Affiliations

Marker events associated with adherence to HIV/AIDS treatment in a cohort study

[Article in English, Portuguese]
Rafael Steffens Martins et al. Rev Saude Publica. .

Abstract
in English, Portuguese

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.

OBJETIVO: Analisar como eventos clínicos e sociais podem impactar na adesão ao tratamento antirretroviral para o HIV.

MÉTODOS: Trata-se de um estudo de coorte histórica com 528 pacientes que realizaram o tratamento para o HIV em um serviço de assistência especializada em Alvorada, RS. Foram analisadas 3429 consultas executadas entre os anos de 2004 e 2017. Para cada consulta, foram coletados dados de características do tratamento e do quadro clínico dos pacientes. A adesão, aferida pelo autorrelato dos pacientes, foi o desfecho do estudo. O modelo de regressão logística via equações de estimação generalizadas foi utilizado para estimação das associações.

RESULTADOS: 67,8% dos pacientes analisados possuem até 8 anos de estudos e 24,8% têm histórico de uso de crack e/ou cocaína. Entre os homens, estar assintomático [razão de chances (RC) = 1,43; IC95% 1,05–1,93], possuir mais de 8 anos de estudo (RC = 2,32; IC95% 1,27–4,23) e nunca ter usado crack (RC = 2,35; IC95% 1,20–4,57) estiveram associados à adesão. Para as mulheres, possuir mais de 24 anos (RC = 1,82; IC95% 1,09–3,02), nunca ter usado cocaína (RC = 2,54; IC95% 1,32–4,88) e estar em gestação (RC = 3,28; IC95% 1,83–5,89) aumentaram as chances de adesão.

CONCLUSÕES: Além de características sociodemográficas definidas, eventos pontuais que podem ocorrer na trajetória de pacientes em tratamentos longos, como início de uma nova gestação e não apresentar sintomas, podem impactar nas chances de adesão dos pacientes ao tratamento.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

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