title: [Challenges of treatment adherence by people living with HIV/AIDS in Brazil].
abstract: OBJECTIVE
  To analyze the difficulties related to treatment adherence by patients living with HIV/AIDS in highly active antiretroviral therapy.
  
  
  METHODS
  Qualitative research based on 34 interviews with patients under treatment in several outpatient services in the state of São Paulo, in 1998-1999. The group was comprised of people from different socioeconomic levels, gender, length of treatment and varied adherence levels, according to healthcare staff perception. The interviews focused on the patient's narrative about his/her disease. The content analysis classified the difficulties as follows: related to social factors and life styles, including the stigma; related to beliefs about the use of medication; and directly related to the use of medication.
  
  
  RESULTS
  All the interviewees reported having difficulties concerning the stigma of living with HIV/AIDS. The difficulties related to the use of medication were the most important among patients with the best adherence level. Patients with average adherence level presented all three types of difficulties.
  
  
  CONCLUSIONS
  Social and cultural factors are more difficult to be overcome in order to achieve treatment adherence than those related to taking medication, thus making the role played by the health sector important, supported by clear public social policies. These dimensions must be faced not only in the health sector, but also on social and political levels.
authors: Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brasil. reginamelchior@gmail.com
authors: Regina
authors: R
authors: Melchior
authors: Maria Ines Battistella
authors: MI
authors: Nemes
authors: Tatianna Meireles Dantas
authors: TM
authors: Alencar
authors: Cássia Maria
authors: CM
authors: Buchalla
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000592:standards; D019380:Anti-HIV Agents / Q000600:supply & distribution / Q000627:therapeutic use*; D001938:Brazil; D005190:Family; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D008019:Life Style; D008297:Male; D010348:Patient Care Team; D010349:Patient Compliance; D011287:Prejudice; D036301:Qualitative Research; D012959:Socioeconomic Factors
chemical_list: D019380:Anti-HIV Agents