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

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.