title: Association between smoking, crack cocaine abuse and the discontinuation of combination antiretroviral therapy in Recife, Pernambuco, Brazil.
abstract: Despite the effectiveness of combination antiretroviral therapy in the treatment of people living with HIV/AIDS (PLWHA), nonadherence to medication has become a major threat to its effectiveness. This study aimed to estimate the prevalence of self-reported irregular use of antiretroviral therapy and the factors associated with such an irregularity in PLWHA. A cross-sectional study of PLWHA who attended two referral centers in the city of Recife, in Northeastern Brazil, between June 2007 and October 2009 was carried out. The study analyzed socioeconomic factors, social service support and personal habits associated with nonadherence to antiretroviral therapy, adjusted by multivariable logistic regression analysis. The prevalence of PLWHA who reported irregular use of combination antiretroviral therapy (cART) was 25.7%. In the final multivariate model, the irregular use of cART was associated with the following variables: being aged less than 40 years (OR = 1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) or former smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR = 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards each of the following groups: individuals aged less than 40 years, smokers, former smokers and crack cocaine users. Measures for giving up smoking and crack cocaine should be incorporated into HIV-control programs in order to promote greater adherence to antiretroviral drugs and thus improve the quality of life and prolong life expectancy.
authors.affiliation: Universidade Federal de Pernambuco, RecifePernambuco, Brazil, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Joanna d'Arc Lyra
authors.initials: Jd
authors.lastname: Batista
authors.affiliation: Centro de Pesquisas Aggeu Magalhães/FIOCRUZ, RecifePernambuco, Brazil, Centro de Pesquisas Aggeu Magalhães/FIOCRUZ, Recife, Pernambuco, Brazil.
authors.forename: Maria de Fátima Pessoa Militão de
authors.initials: Mde F
authors.lastname: Albuquerque
authors.affiliation: Centro de Pesquisas Aggeu Magalhães/FIOCRUZ, RecifePernambuco, Brazil, Centro de Pesquisas Aggeu Magalhães/FIOCRUZ, Recife, Pernambuco, Brazil.
authors.forename: Marcela Lopes
authors.initials: ML
authors.lastname: Santos
authors.affiliation: Universidade de Pernambuco, RecifePernambuco, Brazil, Universidade de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Demócrito de Barros
authors.initials: Dde B
authors.lastname: Miranda-Filho
authors.affiliation: Universidade Federal de Pernambuco, RecifePernambuco, Brazil, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Heloísa Ramos
authors.initials: HR
authors.lastname: Lacerda
authors.affiliation: Hospital Correia Picanço, Secretaria de Saúde, RecifePernambuco, Brazil, Hospital Correia Picanço, Secretaria de Saúde, Recife, Pernambuco, Brazil.
authors.forename: Magda
authors.initials: M
authors.lastname: Maruza
authors.affiliation: Universidade Federal de Pernambuco, RecifePernambuco, Brazil, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Libia Vilela
authors.initials: LV
authors.lastname: Moura
authors.affiliation: Universidade de Pernambuco, RecifePernambuco, Brazil, Universidade de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Isabella
authors.initials: I
authors.lastname: Coimbra
authors.affiliation: Universidade Federal de Pernambuco, RecifePernambuco, Brazil, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
authors.forename: Ricardo Arraes de Alencar
authors.initials: RA
authors.lastname: Ximenes
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000150:complications*; D016578:Crack Cocaine; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D012959:Socioeconomic Factors; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents; D016578:Crack Cocaine