Adherence to antiretroviral therapy and the associated factors among people living with HIV/AIDS in Northern Peru: a cross-sectional study.

Autor: Leyva-Moral JM; Departament d'Infermeria, Facultat de Medicina, Universitat Autonoma de Barcelona, Avda. Can Domenech, Building M. Office M3/211, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain.; Center for Health Sciences Research, Universidad María Auxiliadora, Av. Canto Bello 431, San Juan de Lurigancho, Lima, Lima, 15408, Peru.; Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Universitat Autonoma de Barcelona, Avda. Can Domenech, Building M. Office M3/211, 08193 Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain., Loayza-Enriquez BK; Department of Research, Hospital Regional Lambayecue, Pro. Augusto B. Leguia Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru.; School of Nursing, Universidad Nacional Pedro Ruiz Gallo, Av. Juan XXIII 391, Lambayeque, Chiclayo, 14013, Peru., Palmieri PA; Center for Health Sciences Research, Universidad María Auxiliadora, Av. Canto Bello 431, San Juan de Lurigancho, Lima, Lima, 15408, Peru. Patrick.Palmieri@globalnursing.org.; College of Health Sciences, Universidad Norbert Wiener, Av. Arequipa 444, Lima, Lima, 15046, Peru. Patrick.Palmieri@globalnursing.org.; E​vidence-​B​ased ​H​ealth ​C​are​ South America: A Joanna Briggs Institute Affiliated Group, Universidad María Auxiliadora, Av. Canto Bello 431, San Juan de Lurigancho, Lima, Lima, 15408, Peru. Patrick.Palmieri@globalnursing.org.; Doctor of Health Sciences Program, College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO, 63501, USA. Patrick.Palmieri@globalnursing.org., Guevara-Vasquez GM; Department of Research, Hospital Regional Lambayecue, Pro. Augusto B. Leguia Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru.; E​vidence-​B​ased ​H​ealth ​C​are​ South America: A Joanna Briggs Institute Affiliated Group, Universidad María Auxiliadora, Av. Canto Bello 431, San Juan de Lurigancho, Lima, Lima, 15408, Peru., Elias-Bravo UE; Coordinator HIV/AIDS Unit, Department of Nursing, Hospital Regional Lambayeque, Pro. Augusto B. Leguía Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru., Edwards JE; Center for Global Nursing, Texas Woman's University, 6700 Fannin St, Houston, TX, 77030, USA., Feijoo-Cid M; Departament d'Infermeria, Facultat de Medicina, Universitat Autonoma de Barcelona, Avda. Can Domenech, Building M. Office M3/211, Bellaterra (Cerdanyola del Vallès), 08193, Barcelona, Spain., Davila-Olano LY; Midwife, Department of Obstetrics, Hospital Regional Lambayeque, Pro. Augusto B. Leguia Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru., Rodriguez-Llanos JR; Department of Medicine, Hospital Regional Lambayeque, Pro. Augusto B. Leguia Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru., Leon-Jimenez FE; School of Medicine, Universidad Santo Toribio Mogrovejo, Av. San Josemaría Escriva de Balaguer 855, Chiclayo, Lambayeque, 14101, Peru.; Department of Medicine, Hospital Regional Lambayeque, Lambayeque, Pro. Augusto B. Leguia Nro. 100 (Esquina con Av. Progreso N. 110-120), Chiclayo, Lambayeque, 14101, Peru.
Jazyk: angličtina
Zdroj: AIDS research and therapy [AIDS Res Ther] 2019 Aug 28; Vol. 16 (1), pp. 22. Date of Electronic Publication: 2019 Aug 28.
DOI: 10.1186/s12981-019-0238-y
Abstrakt: Background: There are approximately 72,000 people living with HIV/AIDS (PLHIV) in Peru. Non-adherence to antiretroviral therapy (ART) is the most important factor for therapeutic failure and the development of resistance. Peru has achieved moderate progress in meeting the 90-90-90 targets, but only 60% of PLHIV receiving ART are virally suppressed. The purpose of this study was to understand ART adherence in the Peruvian context, including developing sociodemographic and clinical profiles, evaluating the clinical management strategies, and analyzing the relationships between the variables and adherence of PLHIV managed at a regional HIV clinic in Lambayeque Province (Northern Peru).
Methods: This was a cross-sectional study with 180 PLHIV adults, non-randomly but consecutively selected with self-reported ART compliance (78.2% of the eligible population). The PLHIV profile (PLHIV-Pro) and the Simplified Medication Adherence Questionnaire (SMAQ) were used to collect sociodemographic information, clinical variables, and data specific to ART adherence. Descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was performed with the Mann-Whitney test, Chi square test, and Yates correction.
Results: The 180 PLHIV sample included 78.9% men, 49.4% heterosexual, 45% with a detectable HIV-1 viral load less than 40 copies/ml, 58.3% not consistently adherent, and only 26.1% receiving Tenofovir + Lamivudine + Efavirenz. Risk factors significant for non-adherence included concurrent tuberculosis, discomfort with the ART regime, and previous pauses in ART. Multivariate analysis of nested models indicated having children is a protector factor for adherence.
Conclusions: Self-reported adherence appeared to be low and the use of first-line therapy is not being prescribed homogeneously. Factors associated with nonadherence are both medical and behavioral, such as having tuberculosis, pausing ART, or experiencing discomfort with ART. The Peruvian government needs to update national technical standards, monitor medication availability, and provide education to health care professionals in alignment with evidence-based guidelines and international recommendations. Instruments to measure adherence need to be developed and evaluated for use in Latin America.
Databáze: MEDLINE
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