[Factors related to refuse antiretroviral therapy in prison].
BACKGROUND
Despite the benefits of highly-active antiretroviral therapy (HAART) on morbidity and mortality, some seropositive patients refuse to accept this treatment. Prisons provide easier access to this population.


OBJECTIVE
To determine the psychosocial characteristics of prisoners who refuse HAART.


METHODS
We performed a cross-sectional study in 580 seropositive prisoners in 3 hospitals in Andalusia (Spain). The dependent variable was being under treatment or refusal to be so. The independent variables were sociodemographic and psychosocial factors related to the prison environment and clinical factors related to health status and drug addiction. A logistic regression analysis was performed to determine which factors were related with refusal to accept HAART.


RESULTS
HAART was recommended to 73.1% of seropositive prisoners. This treatment was refused by 23.1% of these prisoners and was accepted by 76.9%. The factors related to refusal to accept HAART were high viral load, worse self-perceived health status, a greater number of stays in prison, and being visited by persons other than relatives.


CONCLUSIONS
There is a group of prisoners with specific characteristics that refuse HAART. Specific interventions should be performed in these prisoners to make them aware of the effects of their decision on the course of their disease.
Sordo del Castillo
Luis
L
Servicio de Medicina Preventiva, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain.
Ruiz Pérez
Isabel
I
Olry Labry de Lima
Antonio
A
Soto Blanco
José Manuel
JM
Antón Basanta
José Joaquín
JJ
Girela López
Eloy
E
Castro Recio
José Manuel
JM
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D006679:HIV Seropositivity / Q000188:drug therapy / Q000523:psychology; D006304:Health Status; D006801:Humans; D008297:Male; D011329:Prisoners / Q000523:psychology*; D011330:Prisons; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data
D019380:Anti-HIV Agents