FACTORS ASSOCIATED WITH SELF-REPORTED DIFFICULTY WITH ANTIRETROVIAL THERAPY IN BRAZIL: GENDER DIFFERENCES
METHODS: Cross-sectional national representative sample of adult patients under ART in 17 AIDS referral services in Brazil. Patients were proportionally sampled according to seven Brazilian Regions and strata of service quality. Patients answered to a face-to-face interview with 38 structured questions and three open-ended questions on ART. Responses to the question “Could you tell me 3 things that make it difficult for you to take drugs for HIV treatment?” were dichotomized in yes/no (yes: at least one difficulty; no: no difficulties). We conducted bivariate analysis to assess the association of behavioral, socioeconomic and treatment-related factors with self-reported difficulty in taking ART. Odds ratios were estimated overall and by gender, with 95% confidence intervals.
RESULTS: Among 598 participants, 39% were women. Self-reported difficulty among women was 7% higher than among men, although the difference showed no significance (p=.14). In the overall analysis, having difficulty was associated with younger age (p<.01), poor self-reported quality of life and health (p<.01), missing doses in the last 6 months (p<.01), experiencing physical adverse events (p<.01) and diagnosis of anxiety (p<.01). Among women, factors associated with reported difficulty were low CD4+ cell count in the last medical exam (p<.01), alcohol use (p<.05) and missing a medical appointment (p<.01). Among men, only recreational illicit drug use (p<.01) was associated with difficulty taking ART.
CONCLUSIONS: Gender-stratified analysis demonstrated that different behavioral and treatment-related factors are associated with reporting any difficulty in taking ART. Understanding gender differences in experiencing difficulty with ART is important to target individuals with higher likelihood of developing non-adherence, thus bound to treatment failure.