Factors Influencing Adherence to Anti-retroviral Therapy in Amazonian Indigenous People Living With Hiv/aids

Abstract

Abstract Background: Indigenous communities in Peru has been historically affected by high mortality rates attributable to HIV-AIDS infection, associated with a low access to health services, and socio-cultural barriers. In this context, the study aimed to describe factors associated with antiretroviral treatment adherence in people from awajun and wampis indigenous communities, living with HIV-AIDS in a peruvian amazonian region. Methods. A cross-sectional study, which was completed in a consecutive sample of people from indigenous communities (awajun or wampis) living with HIV, who are received antiretroviral treatment at least on the last three months. Participants were recruited between October 1 and December 30, 2021, from four districts of Bagua and Condorcanqui provinces – Amazonian region. An ad-hoc questionnaire was applied to collect information about demographical, economical, and socio-cultural factors and access to health services; and the Simplified Medication Adherence Questionnaire (SMAQ) was performed to evaluate the adherence to antiretroviral therapy. Multivariate logistic regression analysis with backward stepwise were performed to explore factors that might influence adherence. Results: Of the 208 participants, 28.8% reported complete adherence to antiretroviral treatment. The multivariate logistic regression showed that occupation (aPR: 1.86; 95%CI 1.15-3.02), economic income (aPR: 0.64; 95%CI 0.41-0.99), and adverse reactions to antiretroviral therapy (aPR: 0.36; 95%CI 0.18-0.70) were related with complete adherence to medication. Conclusions: Only a third of participants reported a complete adherence to antiretroviral therapy. Factors associated with adherence to antiretroviral medication were related to socioeconomic conditions and adverse reactions to therapeutic scheme. Interventions related to improve adherence in indigenous people living with HIV should have to consider these factors in order to develop effective implementation strategies.