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Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy

OBJECTIVE: We conducted a study to identify gender differences in factors associated with the first episode of non-adherence in the 12 months following the first antiretroviral prescription. METHODS: A concurrent prospective study of patients initiating antiretroviral therapy in Brazil was conducted...

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Autores principales: de Fatima Bonolo, Palmira, Ceccato, Maria das Graças Braga, Rocha, Gustavo Machado, de Assis Acúrcio, Francisco, Campos, Lorenza Nogueira, Guimarães, Mark Drew Crosland
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654293/
https://www.ncbi.nlm.nih.gov/pubmed/23778401
http://dx.doi.org/10.6061/clinics/2013(05)06
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author de Fatima Bonolo, Palmira
Ceccato, Maria das Graças Braga
Rocha, Gustavo Machado
de Assis Acúrcio, Francisco
Campos, Lorenza Nogueira
Guimarães, Mark Drew Crosland
author_facet de Fatima Bonolo, Palmira
Ceccato, Maria das Graças Braga
Rocha, Gustavo Machado
de Assis Acúrcio, Francisco
Campos, Lorenza Nogueira
Guimarães, Mark Drew Crosland
author_sort de Fatima Bonolo, Palmira
collection PubMed
description OBJECTIVE: We conducted a study to identify gender differences in factors associated with the first episode of non-adherence in the 12 months following the first antiretroviral prescription. METHODS: A concurrent prospective study of patients initiating antiretroviral therapy in Brazil was conducted from 2001-2002. The self-reported measurement of adherence was defined as an intake of less than 95% of the prescribed number of doses. Only the first occurrence of non-adherence was considered in this analysis. All analyses were stratified by gender. A Cox proportional hazard model was used to estimate the risk of non-adherence, and the time to non-adherence was estimated using the Kaplan-Meier method. RESULTS: The cumulative incidence of non-adherence was 34.6% (29.7% and 43.9% among men and women, respectively; p = 0.010). Marital status (being married or in stable union; p = 0.022), alcohol use in the month prior to the baseline interview (p = 0.046), and current tobacco use (p = 0.005) increased the risk of non-adherence among female participants only, whereas a self-reported difficulty with the antiretroviral treatment was associated with non-adherence in men only. For both men and women, we found that a longer time between the HIV test and first antiretroviral therapy prescription (p = 0.028) also presented an increased risk of non-adherence. CONCLUSIONS: In this cohort study, the incidence of non-adherence was 1.5 times greater among women compared to men. Our results reinforce the need to develop interventions that account for gender differences in public referral centers. Additionally, we emphasize that, to achieve and maintain appropriate adherence levels, it is important to understand the barriers to seeking and utilizing health care services.
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spelling pubmed-36542932013-05-17 Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy de Fatima Bonolo, Palmira Ceccato, Maria das Graças Braga Rocha, Gustavo Machado de Assis Acúrcio, Francisco Campos, Lorenza Nogueira Guimarães, Mark Drew Crosland Clinics (Sao Paulo) Clinical Science OBJECTIVE: We conducted a study to identify gender differences in factors associated with the first episode of non-adherence in the 12 months following the first antiretroviral prescription. METHODS: A concurrent prospective study of patients initiating antiretroviral therapy in Brazil was conducted from 2001-2002. The self-reported measurement of adherence was defined as an intake of less than 95% of the prescribed number of doses. Only the first occurrence of non-adherence was considered in this analysis. All analyses were stratified by gender. A Cox proportional hazard model was used to estimate the risk of non-adherence, and the time to non-adherence was estimated using the Kaplan-Meier method. RESULTS: The cumulative incidence of non-adherence was 34.6% (29.7% and 43.9% among men and women, respectively; p = 0.010). Marital status (being married or in stable union; p = 0.022), alcohol use in the month prior to the baseline interview (p = 0.046), and current tobacco use (p = 0.005) increased the risk of non-adherence among female participants only, whereas a self-reported difficulty with the antiretroviral treatment was associated with non-adherence in men only. For both men and women, we found that a longer time between the HIV test and first antiretroviral therapy prescription (p = 0.028) also presented an increased risk of non-adherence. CONCLUSIONS: In this cohort study, the incidence of non-adherence was 1.5 times greater among women compared to men. Our results reinforce the need to develop interventions that account for gender differences in public referral centers. Additionally, we emphasize that, to achieve and maintain appropriate adherence levels, it is important to understand the barriers to seeking and utilizing health care services. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2013-05 /pmc/articles/PMC3654293/ /pubmed/23778401 http://dx.doi.org/10.6061/clinics/2013(05)06 Text en Copyright © 2013 Hospital das Clínicas da FMUSP http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Science
de Fatima Bonolo, Palmira
Ceccato, Maria das Graças Braga
Rocha, Gustavo Machado
de Assis Acúrcio, Francisco
Campos, Lorenza Nogueira
Guimarães, Mark Drew Crosland
Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title_full Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title_fullStr Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title_full_unstemmed Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title_short Gender differences in non-adherence among Brazilian patients initiating antiretroviral therapy
title_sort gender differences in non-adherence among brazilian patients initiating antiretroviral therapy
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3654293/
https://www.ncbi.nlm.nih.gov/pubmed/23778401
http://dx.doi.org/10.6061/clinics/2013(05)06
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