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Treatment Adherence, Quality of Life and Clinical Variables in HIV/AIDS Infection

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DOI: 10.4236/wja.2013.33032    5,449 Downloads   7,734 Views   Citations


The purpose of the study was to analyze the relationship between treatment adherence, quality of life and clinical variables in HIV/AIDS Infection. The empirical study was conducted at two Portuguese hospitals (Porto and Lisbon) with a sample of 295 outpatients diagnosed with HIV/AIDS attending the Infectology service and on antiretroviral medication, during a 12-month period (February 2009 to February 2010). Data were collected by voluntary fulfillment of three questionnaires: one for socio-demographic variables, one to Assess Adherence to Antiretroviral Treatment-HIV and the Portuguese version of the WHOQOL-Bref to measure the quality of life (QoL). Clinical records were inspected in order to collect clinical information from the patients. The relationship between these variables was accessed by Student’s t-test and ANOVA using Tukey and LSD as the post Hoc test. Regarding disease stages, the post Hoc analysis has showed that asymptomatic patients have a better level of adherence and quality of life when compared to those in more advanced stages of the disease. Undetectable viral load <20 copies/mL and T CD4+ count >500 cells/mm3 were also associated with higher QoL in all overall domains. Patients on NRTI + NNTRI regimens have higher adherence when compared to those on NRTI + PI regimens and higher QoL indexes when compared to twice daily regimens, patients on single dose per day regimens have higher adherence and higher QoL in overall domain. Patients experiencing adverse effects have lower QoL and lower adherence levels when compared to those not experiencing such events. We consider the multiplicity and the interaction of several determinants of influence in the adaptation process during the HIV/AIDS treatment. The results may have implications for the psychological intervention to improve the adherence’s level to the antiretroviral therapy.

Conflicts of Interest

The authors declare no conflicts of interest.

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A. Reis, M. Guerra and L. Lencastre, "Treatment Adherence, Quality of Life and Clinical Variables in HIV/AIDS Infection," World Journal of AIDS, Vol. 3 No. 3, 2013, pp. 239-250. doi: 10.4236/wja.2013.33032.


[1] O. Alvis, L. De Coll, L. Chumbimune, C. Díaz, J. Díaz, et al., “Factores Associados a la No Adherencia al Tratamento Antirretroviral en Adultos Infectados con el VIH/ SIDA,” Anales de la Facultad de Medicina, Vol. 70, No. 4, 2009, pp. 266-272.
[2] R. Sarmento, “Terapêutica Anti-Retrovírica Inicial,” In H. Lecour and R. Sarmento, Eds., Infecao VIH/SIDA: 2 Curso de Pós-Graduacao, Portugal, 2004, pp. 327-338.
[3] P. A. Volderbing, “Início da Terapêutica Para o VIH,” Postgraduate Medicine, Vol. 22, No. 1, 2004, pp. 83-90.
[4] M. A. Chesney, J. R. Ickovics, D. B. Chambers, A. L. Gifford, J. Neidig, et al., “Self-Reported Adherence to Antiretroviral Medications among Participants in HIV Clinical Trials: The AACTG Adherence Instruments,” AIDS CARE, Vol. 12, No. 3, 2000, pp. 255-266.
[5] E. Gir, C. G. Vaichulonis and M. D. Oliveira, “Adesao à Terapêutica Antirretroviral por Indivíduos com HIV/ AIDS Assistidos em uma Instituicao do Interior Paulista,” Revista Latino-Americana de Enfermagem, Vol. 13, No. 5, 2005.
[6] E. Remor, “Valoración de la Adhesión al Tratamiento Antirretroviral en Pacientes VIH+,” Psicothema, Vol. 14, No. 2, 2002, pp. 262-267.
[7] E. Remor, J. Milner-Moskovics and G. Preussler, “Adaptacao Brasileira do ‘Cuestionario para la Evaluación de la Adhesión al Tratamiento Antirretroviral’,” Revista de Saúde Pública, Vol. 41, No. 5, 2007, pp. 685-694.
[8] E. Remor, “Intervención del Psicólogo en una Unidad de Tratamiento de Pacientes con Infección por VIH/SIDA,” In: E. Remor, P. Arranz and S. Ulla, Eds., El Psicólogo en el ámbito Hospitalario, DDB, Bilbao, 2003, pp. 309-348.
[9] R. Margalho, M. Pereira, S. Ouakinin and M. C. Canavarro, “Adesao à HAART, Qualidade de vida e Sintomatologia Psicopatológica em Doentes Infetados pelo VIH/ SIDA,” Acta Med Port, Vol. 24, No. S2, 2011, pp. 539-548.
[10] A. Amassari, M. P. Trotta, R. Murri, F. Castelli, P. Narciso, et al., “Correlates and Predictors of Adherence to Highly Active Antiretroviral Therapy: Overview of Published Literature,” Journal of Acquired Immune Deficiency Syndromes, Vol. 31, No. 3, 2002, pp. 123-127.
[11] X. Gao, “The Relationship of Disease Severity, Health Beliefs and Medication Adherence among HIV Patients,” Master Thesis, West Virginia University, Morgantown, 1999.
[12] A. Reis, “Adesao Terapêutica na Infecao pelo vírus da Imunodeficiência Humana (Tese de Mestrado nao Publicada,” Faculdade de Psicologia e de Ciências da Educacao da Universidade do Porto, Porto, 2007.
[13] A. Reis, “Avaliacao da Adesao Terapêutica na Infecao VIH/SIDA e Compreensao de Variáveis Psicológicas Associadas,” Tese de Doutoramento nao Publicada, Faculdade de Psicologia e de Ciências da Educacao da Universidade do Porto, Porto, 2012.
[14] V. E. Stone, J. W. Hogan and P. Schuman, “Antiretroviral Regimen Complexity, Self-Reported Adherence, and HIV Patients’ Understanding of Their Regimens: Survey of Women in the HER Study,” Journal of Acquired Immune Deficiency Syndromes, Vol. 28, 2001, p. 12.
[15] I. Al-Dakkak, S. Patel, E. McCann, A. Gadkari, G. Prajapati and E. M. Maiese, “The Impact of Specific HIV Treatment-Related Adverse Events on Adherence to Antiretroviral Therapy: A Systematic Review and Meta-Analysis. AIDS Care, 2012.
[16] A. Reis, L. Lencastre, M. Guerra and E. Remor, “Adaptacao Portuguesa do Questionário para Avaliacao da Adesao ao Tratamento Antiretrovírico-VIH (CEAT-VIH),” Psicologia, Saúde & Doencas, Vol. 10, No. 2, 2009, pp. 175-191.
[17] A. Vaz Serra, M. C. Canavarro, M. Simoes, M. Pereira, S. Gameiro, et al., “Estudos Psicométricos do Instrumento de Avaliacao da Qualidade de Vida da Organizacao Mundial da Saúde (WHOQOL-Bref) Para Português de Portugal,” Psiquiatria Clínica, Vol. 27, No. 1, 2006, pp. 41-49.
[18] Centre for Disease Control, “Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS among Adolescents and Adults,” 1993.
[19] E. Remor, “Manual del Cuestionario para la Evaluación de la Adhesión al Tratamiento Antirretroviral en Personas con Infección por VIH Y Sida. Guía para el usuario del Cuestionario para la Evaluación de la Adhesión al Tratamiento Antirretroviral en Personas con Infección por VIH Y Sida (CEAT-VIH),” Facultad de Psicología/Universidad Autónoma de Madrid, Madrid, 2009.
[20] M. L. Urbina, “Evaluación de Factores Asociados a la Baja Adherencia al TAR en Personas con VIH/SIDA, Porcentajes de Ocurrencia y Resultado del Desarrollo de Estratégias Según Hallazgos, en Correlación con la Carga Viral. Comunicacao Apresentada ao VI Encuentro Nacional de Investigación en Enfermedades Infeciosas de la Asociación Colombiana de Infectologia. Santa Marta, Colombia, 2008.
[21] E. Remor, “International Psychometric Study of the Adherence to Antiretroviral Treatment Questionnaire,” Paper presented at 22nd Annual Conference of the European Health Psychology Society & 11th Annual Conference of the BPS Division of Health Psychology, Bath, 2008.
[22] E. Tafur-Valderrama, C. Ortiz, C. O. Alfaro, E. García-Jímenez and M. J. Faus, “Adaptación del Cuestionario de Evaluación de la Adhesión al Tratamento Antiretroviral CEAT-VIH para su uso en Peru,” ARS Pharmaceutica, Vol. 49, No. 3, 2008, pp. 183-198.
[23] A. Dima, A. M. Schweitzer, R. Neculau, E. Remor and S. Wanless, “Adherence to Antiretroviral Medication in Romanian Adolescents: Adaptation of CEAT-VIH Questionnaire,” Poster Presented at the 24th Annual Conference of the European Health Psychology Society, Cluj, Romania, 2010.
[24] X. Gao, P. Nau, S. Rosenbluth, V. Scott and C. Woodward, “The Relationship of Disease Severity, Health Beliefs and Medication Adherence among HIV Patients,” AIDS Care, Vol. 12, No. 4, 2000, pp. 387-398.
[25] J. J. Parienti, D. R. Bangsberg, R. Verdon and E. M. Gardner, “Better Adherence with Once-Daily Antiretroviral Regimens: A Meta-Analysis,” Clinical Infectious Diseases, Vol. 48, No. 4, 2009, pp. 484-488.
[26] M. J. Atkinson and J. J. Petrozzino, “An Evidence-Based Review of Treatment-Related Determinants of Patients’ Nonadherence to HIV Medications,” AIDS Patient Care STDS, Vol. 23, No. 1, 2009, pp. 903-914.
[27] S. Bangalore, G. Kamalakkannan and S. Parkar, “Fixed-Dose Combinations Improve Medication Compliance: A Meta-Analysis,” The American Journal of Medicine, Vol. 120, 2007, pp. 713-719.
[28] F. Pulido, E. Ribera, S. Moreno, A. Munoz, D. Podzamczer, et al., “Once-Daily Antiretroviral Therapy: Spanish Consensus Statement,” Journal of Antimicrobial Chemotherapy, Vol. 56, No. 5, 2005, pp. 808-818.
[29] K. Berg, A. Demas, A. Howard, E. Schoenbaum, M. Gourevitch and J. Arnsten, “Gender Differences in Factors Associated with Adherence to Antiretroviral Therapy,” Journal of General Internal Medicine, Vol. 19, 2004, pp. 1111-1117.
[30] A. Reis, L. Lencastre, M. Guerra and E. Remor, “Relacao Entre Sintomatologia Psicopatológica, Adesao ao Tratamento e Qualidade de vida na Infecao Pelo HIV e AIDS,” Psicologia: Reflexao & Crítica, Vol. 23, No. 3, 2010, pp. 420-429.
[31] L. Campos, C. César and M. Guimaraes, “Quality of Life among HIV-Infected Patients in Brazil after Initiation of Treatment,” Clinic Science, Vol. 64, No. 9, 2009, pp. 867-875.
[32] G. Jones, K. Hawkins, R. Mullin, T. Nepusz, D. P. Naughton, et al., “Understanding How Adherence Goals Promote Adherence Behaviours: A Repeated Measure Observational Study with HIV Seropositive Patients,” BMC Public Health, Vol. 12, 2012, p. 587.

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