title: Vulnerability and non-adherence to antiretroviral therapy among HIV patients, Minas Gerais State, Brazil.
abstract: The aim of the present study was to describe vulnerability profiles and to verify their association with non-adherence to antiretroviral therapy (ART) among 295 HIV-patients receiving their first prescription in two public-referral centers in Minas Gerais States, Brazil. The cumulative incidence of non-adherence was 36.9%. Three pure vulnerability profiles (lower, medium and higher) were identified based on the Grade of Membership method (GoM). Pure type patients of the "higher vulnerability" profile had, when compared to the overall sample, an increased probability of being younger, not understanding the need of ART, having a personal reason to be HIV-tested, not disclosing their HIV status, having more than one (non-regular) sexual partner, reporting use of alcohol, tobacco and illicit drugs, and having sex among men. Non-adherence to ART was statistically associated (p < 0.001) with this profile. Also, the heterogeneity of the sample was found to be high, since over 40% were mixed type. The implications are that health staff should be trained to develop strategies for incorporating risk-reduction interventions, bearing in mind the three dimensions of vulnerability and the diversity of those patients initiating antiretroviral therapy.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
authors.forename: Palmira de Fátima
authors.initials: Pde F
authors.lastname: Bonolo
authors.forename: Carla Jorge
authors.initials: CJ
authors.lastname: Machado
authors.forename: Cibele Comini
authors.initials: CC
authors.lastname: César
authors.forename: Maria das Graças Braga
authors.initials: Md
authors.lastname: Ceccato
authors.forename: Mark Drew Crosland
authors.initials: MD
authors.lastname: Guimarães
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D005260:Female; D017143:Fuzzy Logic; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012725:Sexual Behavior / Q000187:drug effects; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult; D016903:Drug Monitoring