The influence of depressive symptoms and substance use on adherence to antiretroviral therapy: a cross-sectional prevalence study

• Autor(a) principal: Tufano, Claudia Siqueira
• Data de Publicação: 2015
• Outros Autores: Amaral, Ricardo Abrantes do, Cardoso, Luciana Roberta Donola, Malbergier, André
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: São Paulo medical journal (Online)
• Texto Completo: https://periodicosapm.emnuvens.com.br/spmj/article/view/1123
• topic: HIV; Depressão; Adesão à medicação; Terapia antirretroviral de alta atividade; Sistema imunológico; HIV; Depression; Medication adherence; Antiretroviral therapy, highly active; Immune system

CONTEXT AND OBJECTIVE: Adherence to antiretroviral treatment (ART) is not a stable condition, but is dynamic, like mental conditions. The aim of this study was to examine whether non-adherence to ART is related to demographic and immunological variables, substance use and presence of depressive symptoms. DESIGN AND SETTING: This was a cross-sectional prevalence study carried out at a public AIDS treatment center in the city of São Paulo, Brazil, between July 2006 and January 2007. METHODS: 438 patients on regular ART schedules with recent laboratory tests answered a demographic questionnaire, questions about substance use, the Hamilton Depression Rating Scale (HDRS) and the Sim-plified Medication Adherence Questionnaire (SMAQ). RESULTS: The prevalence of non-adherence over the past three months (a pattern of treatment interrup-tion) was 46.3%, and 27.2% also reported this in the past week (a pattern of missed doses). ART interrup-tion was significantly related to older age, lower CD4+ cell count and homosexual/bisexual transmission. The pattern of missed doses was significantly related to younger age, higher HDRS scores and higher viral load of RNA HIV. CONCLUSION: ART interruption may reflect recall errors and changes to the Brazilian demographic char-acteristics of HIV infection. The missed doses may reflect lifestyle characteristics of younger individuals. Attendance for HIV-positive individuals, particularly younger patients, should involve interventions and counseling in relation to the presence of depressive symptoms.