title: Difficulties reported by HIV-infected patients using antiretroviral therapy in Brazil.
abstract: OBJECTIVE
  To describe the degree of difficulty that HIV-infected patients have with therapy treatment.
  
  
  BACKGROUND
  Patients perceptions about their treatment are a determinant factor for improved adherence and a better quality of life.
  
  
  METHODS
  Two cross-sectional analyses were conducted in public AIDS referral centers in Brazil among patients initiating treatment. Patients interviewed at baseline, after one month, and after seven months following the beginning of treatment were asked to classify and justify the degree of difficulty with treatment. Logistic regression was used for analysis.
  
  
  RESULTS
  Among 406 patients initiating treatment, 350 (86.2%) and 209 (51.5%) returned for their first and third visits, respectively. Treatment perceptions ranged from medium to very difficult for 51.4% and 37.3% on the first and third visits, respectively. The main difficulties reported were adverse reactions to the medication and scheduling. A separate logistic regression indicated that the HIV-seropositive status disclosure, symptoms of anxiety, absence of psychotherapy, higher CD4+ cell count (> 200/mm3) and high (> 4) adverse reaction count reported were independently associated with the degree of difficulty in the first visit, while CDC clinical category A, pill burden (> 7 pills), use of other medications, high (> 4) adverse reaction count reported and low understanding of medical orientation showed independent association for the third visit.
  
  
  CONCLUSIONS
  A significant level of difficulty was observed with treatment. Our analyses suggest the need for early assessment of difficulties with treatment, highlighting the importance of modifiable factors that may contribute to better adherence to the treatment protocol.
authors.affiliation: Department of Preventive and Social Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. drew@medicina.ufmg.br
authors.forename: Mark Drew Crosland
authors.initials: MD
authors.lastname: Guimarães
authors.forename: Gustavo Machado
authors.initials: GM
authors.lastname: Rocha
authors.forename: Lorenza Nogueira
authors.initials: LN
authors.lastname: Campos
authors.forename: Felipe Melo Teixeira
authors.initials: FM
authors.lastname: de Freitas
authors.forename: Felipe Augusto Souza
authors.initials: FA
authors.lastname: Gualberto
authors.forename: Ramiro d' Avila Rivelli
authors.initials: Rd
authors.lastname: Teixeira
authors.forename: Fábio Morato
authors.initials: FM
authors.lastname: de Castilho
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000523:psychology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents