Dificuldades e facilidades associadas ao tratamento antirretroviral: autopercepção de pessoas vivendo com HIV em acompanhamento nos serviços públicos de saúde do Brasil.

• Ano de defesa: 2014
• Autor(a) principal: Celline Cardoso Almeida
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: HIV/AIDS; Percepções do paciente; Adesão; Tratamento antirretroviral; Dificuldades; Facilidades; Infecções por HIV/terapia; Papel do doente; AIDS (Doença); Adesão à medicação; Qualidade de vida; Infecções por HIV/quimioterapia; Atitude frente a saúde; Estudos transversais; Infecções por HIV/psicologia; Cooperação do paciente
• Link de acesso: http://hdl.handle.net/1843/BUBD-A8QM6T

Adherence to antiretroviral therapy (ART) has great relevance to viral suppression and immune reconstitution in most people living with HIV (PLHIV). However, barriers are encountered since the management of the scheme until the impact of HIV in patients life. This study attempted to investigate the perceptions of PLHIV on the use of antiretroviral drugs, to understand the factors that hinder and motivate treatment and evaluate their impact on adherence. This study is part of AVANTs project, a national cross-sectional study with a sample of 2424 PLHIV under ART in 53 public health services. A subsample (n = 598) was selected and submitted to an semistructured interview with three open-ended questions about what were the difficulties with ART, what could make ART easier and what could be done to improve coping with ART. Data were analyzed using a content analysis approach to identify themesthat represent barriers and facilitators with ART. The barriers were used in quantitative analysis to verify their association with the outcome non-adherence, measured by the WebAd-Q, which consists in a four-category scale of nonadherence: zero non-adherence, non-adherence at one, two, or three dimensions (i.e., improper timing, skipping medication and skipping doses). The trend test of Kendalls tau-b was used for univariate analysis and then ordinal regression was conducted. Barriers and facilitators were classified into five categories: social and economic factors, healthcare team and system-related factors,therapy-related factors, factors related to HIV infection and patient-related factors. The barriers interact with one another and may lead to non-compliance, and these relationships are demonstrated through a theoretical model. Based on the suggestions given by the participants about what could be done to improve coping with ART, four stakeholders involved in ART process were identified: managers, health professionals, patients and community. Most participants (62.4%) reported non-adherence to at least one dimension. Patients who reported barriers as alcohol/drug abuse, forgetfulness in taking the pills, uncertainty about future and those who found ART difficult to incorporate into routine were more likely to report non-adherence at more dimensions. Healthcare professionals attending PLHIV should be aware of the motivators or barriers to treatment, and use the facilitators as strategies to overcome the barriers and improve adherence to ART. Patients suggestions should be considered aiming to meet their expectations and thusimprove their coping with treatment and the quality of care.