ANALYSIS OF RETENTION TO ANTIRETROVIRAL THERAPY OF PEOPLE LIVING WITH HIV AND ASSOCIATED FACTORS IN BRAZIL FROM 2014 TO 2022
Name: MARCELO ARAÚJO DE FREITAS
Publication date: 26/03/2025
Examining board:
Name |
Role |
|---|---|
| ANA ROBERTA PASCOM | Coorientador |
| ANGELICA ESPINOSA BARBOSA MIRANDA | Presidente |
| CARLOS GRAEFF TEIXEIRA | Examinador Interno |
| CRISPIM CERUTTI JUNIOR | Examinador Interno |
| FABIO CALDAS MESQUITA | Examinador Externo |
Pages
Summary: INTRODUCTION: Retention in antiretroviral therapy (ART) is essential for controlling
HIV/AIDS and reducing mortality rates worldwide. In Brazil, although ART is widely
accessible, challenges remain in maintaining individuals in treatment over time. This
study aimed to analyze trends in ART retention from 2014 to 2022 in the country.
METHODS: This population-based study used national antiretroviral dispensing
databases from the Ministry of Health to assess retention at 6, 12, 24, 36, 48, and 60
months after treatment initiation. The analysis included individuals aged 15 years or
older, defining retention as a delay in medication dispensing of no more than 28 days.
Additionally, a multivariate analysis was conducted for 60-month retention in the year
2022. RESULTS: The study observed over 3.4 million ART dispensations, revealing that
retention steadily declined over time, with the lowest proportions observed at 60 months
(71% in 2022). Men had consistently higher retention compared to women (79% vs 73%
in 2022). Lower retention was found among younger age groups (74% in 2022),
indigenous populations (67% in 2022), individuals with lower education levels (72% in
2022), and those residing in northern (74% in 2022) regions of Brazil. The multivariate
analysis of 60-month retention in 2022 found a higher likelihood of retention among
individuals without tuberculosis coinfection (OR: 1,26; IC95% 1,17 – 1,36; p=0,000).
CONCLUSIONS: The study highlights significant challenges in retention, especially
after prolonged ART use, with notable disparities across demographic and regional
groups. The findings suggest the need for targeted interventions to improve ART
retention, particularly among vulnerable populations, and may support public health
policies to strengthen continuous HIV care in Brazil.
