Investigação dos aspectos psicológicos da adesão à medicação antirretroviral em pacientes em uso do aplicativo de celular NOPA

Abstract

To ensure the effectiveness of antiretroviral therapy, high levels of treatment adherence are needed for obtaining a virological and/or immunological response and to delay the disease progression in the long term. Without proper adhesion, antiretrovirals (ARVs) aren't kept in sufficient concentration to suppress HIV replication in infected cells and to reduce plasma viremia. Poor adherence to ARV medication is not only associated with shortened immune response, but also induces drug resistance and increases the risk of treatment failure and the disease progression. Although an ideal level of ART adherence is not defined, adherence to medication below 95% is related to a worse immunological and virological response. Thus, an intervention program was conducted to provide adherence to antiretroviral medication in young adult patients, called "Use of mobile phone messaging to promote adherence to antiretroviral therapy in adolescents and young adults infected with HIV-1". The objective of this study was to investigate the influencing factors to antiretroviral medication of the program participants. The study included 22 participants from the clinical group, aged 13-33 years (mean= 21.18 and SD= 6.16) and 44 participants (mean= 21.02 and SD= 6.40) from the control group, which comprised health persons matching age, education and type of school. Correlations between cognitive deficits and the usage behavior were observed, specially in executive function tasks . It was found that the presence of symptoms and/or psychiatric comorbidities correlates with the use of NOPA, the interaction with the application and the post-intervention adhesion percentage. Also, internalized and externalized symptoms correlate negatively, moderated and statistically significantly with the reported adherence to antiretroviral. Correlation between personality traits and the use of NOPA was also found, in a way that the socialization traits and extroversion correlated with positive and meaningful adherence behaviors. It can be concluded that among the factors involved in antiretroviral medication adherence, mild cognitive impairment does not interfere significantly, while psychiatric symptoms and personality characteristics may interfere more significantly in the adherence.