title: Factors associated with lack of antiretroviral adherence among adolescents in a reference centre in Rio de Janeiro, Brazil.
abstract: The objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10-19 years) followed at Instituto de Puericultura e Pediatria Martagão Gesteira and Hospital Universitário Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking > or = 95% of the ARTs (adherent), or < 95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value < or = 0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) = 3.47 (95% confidence interval [CI] = 1.13-10.68); if they do not carry an extra dose of ART, OR = 6.63 (95% CI = 1.73-25.47); if a health-care worker taught them how to take ART, OR = 0.27 (95% CI = 0.08-0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.
authors.affiliation: Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: L F B
authors.initials: LF
authors.lastname: Filho
authors.forename: S A
authors.initials: SA
authors.lastname: Nogueira
authors.forename: E S
authors.initials: ES
authors.lastname: Machado
authors.forename: T F
authors.initials: TF
authors.lastname: Abreu
authors.forename: R H
authors.initials: RH
authors.lastname: de Oliveira
authors.forename: L
authors.initials: L
authors.lastname: Evangelista
authors.forename: C B
authors.initials: CB
authors.lastname: Hofer
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001938:Brazil; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D012307:Risk Factors; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents