ABANDONO DE TRATAMENTO ANTIRRETROVIRAL (TARV) EM PESSOAS QUE VIVEM COM HIV/aids (PVHA) EM CAMPO GRANDE, MATO GROSSO DO SUL

Abstract

Even after 40 years of epidemic, the infection caused by the human immunodeficiency virus (HIV) still represents a global public health problem, despite having become a controllable chronic clinical condition due to the effectiveness of antiretroviral therapy. However, its management presents weaknesses in terms of access to comprehensive care, such as late diagnosis and treatment abandonment, the last being the focus of this study. This research aimed to characterize the abandonment of antiretroviral treatment (ART) among people living with HIV/Aids (PLHA) in the city of Campo Grande – MS and evaluate the strategy for reconnecting these users to antiretroviral treatment. First, a retrospective cross-sectional study was conducted using information from databases of users lost to follow-up/antiretroviral treatment, and then an active search was carried out to re-engage PLHA in medical care. The study population included PLHA over 18 years of age, non-pregnant and lost to follow-up/abandonment of treatment for ≥ 100 days in two specialized HIV/Aids care services from January 2021 to April 2022. A total of 852 PLHA in Loss To Follow Up (LTFU) were included. The majority were men, young adults (average of 38 years), on treatment for more than three months before loss of follow-up, with a CD4+ cell count above 200 cells/μl, and with the last determination of detectable viral load more than 12 months. The rate of non-adherence/relinking to ART in the studied population was 45.76% associated with age greater than or equal to 46 years, CD4 cell count less than 100 cells/uL, time lost to follow-up ≥12 months and more of an active search contact attempt. The last detectable viral load and the time of abandonment greater than or equal to three months were factors associated with re-engagement and consequent return to ART. The strategy of tracking PLHA in LTFU by phone calls was carried out for only 31.69%, however, of these, only 3.39% returned to treatment. The deficit in updating data, monitoring, linkage, retention and correct completion of information systems related to PLHA corroborates the negative outcome. The development of re-engagement strategies is relatively new, with several studies around the world, but research is still limited in Brazil. The results of this study demonstrate the relevance of patient-centered interventions and the need to guarantee early treatment and promote retention in care with consequent viral suppression, impacting the population's health indicators, with an emphasis on health managers and stakeholders in the HIV care.