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

Sao Paulo Medical Journal

Claudia Siqueira Tufano¹  Ricardo Abrantes Do Amaral¹  Luciana Roberta Donola Cardoso¹  André Malbergier¹ 

关键词: HIV;    Depression;    Medication adherence;    Antiretroviral therapy;    highly active;    Immune system;    HIV;    Depressão;    Adesão à medicação;    Terapia antirretroviral de alta atividade;    Sistema imunológico;   

DOI  :  10.1590/1516-3180.2013.7450010

来源: SciELO

【 摘 要 】

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 Simplified Medication Adherence Questionnaire (SMAQ).RESULTS:The prevalence of non-adherence over the past three months (a pattern of treatment interruption) was 46.3%, and 27.2% also reported this in the past week (a pattern of missed doses). ART interruption 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 characteristics 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.

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