[Challenges of treatment adherence by people living with HIV/AIDS in Brazil].
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.
Melchior
Regina
R
Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, PR, Brasil. reginamelchior@gmail.com
Nemes
Maria Ines Battistella
MI
Alencar
Tatianna Meireles Dantas
TM
Buchalla
Cássia Maria
CM
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
D019380:Anti-HIV Agents