AEGiS-13IAC: Social and economic correlates of AIDS multi-drug therapy non-compliance in Brazil.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Social and economic correlates of AIDS multi-drug therapy non-compliance in Brazil.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB418)

Merchan-Hamann E, Vale MS
E. Merchan-Hamann, University of Brasilia, Campus Universitario - Asa Norte, CEP: 70.910-900, DF, Brazil, Tel.: +55 061 274 70 22, Fax: +55 061 274 70 22, E-mail: hamann@unb.br

BACKGROUND: In Brazil, standard AIDS therapy is provided free by the Ministry of Health. A case-control study for predictors of treatment abandonment was carried out in the main AIDS public facility of Taguatinga, Federal District, in 1999.

METHODS: Cases were defined as AIDS patients who abandoned standard treatment for more than two months. Controls were patients in regular use.

RESULTS: Among cases, illegal substance abuse was significantly more likely to occur (OR = 25.5; 95% IC = 4.6-185.0 ; p = 0.0000026), followed by precarious housing and/or homelessness (OR = 13.7 ; 95% IC = 1.5-127.9; p = 0.013), individual monthly income of less than US$ 300.00 (OR = 12.4; 95% IC = 4.0-38.6; p = 0.000001), familial monthly income of less than US$ 300.00 (OR = 9.5 ; 95% IC = 3.3-27.3 ; p = 0.000004). Also, alcohol consumption (OR = 5.4; 95% IC = 2.0-15.2; p = 0.00017), illiteracy or less than 8 years of school (OR = 4.4; 95% IC = 1.6-11.7 ; p = 0.004), and unemployment (OR = 2.6; 95% IC = 1.1-6.5; p = 0.03) were predictors of therapy abandonment. Other variables were not significantly associated. Most patients attributed non-compliance to treatment side-effects.

CONCLUSION: Substance abuse, low income (less than US$ 3,600,00 a year), lack of social and familial support, unemployment and illiteracy are predictors of therapy non-compliance, towards which official policies should be addressed.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, Antiretroviral Therapy, Highly Active, Treatment Refusal, Patient Compliance, Substance-Related Disorders, Alcoholism, Unemployment, Poverty, Case-Control Studies, Brazil, Human, drug therapy, economics, psychology, therapy
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TuOrB418