Doutorado em Doenças Infecciosas

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Navegando Doutorado em Doenças Infecciosas por Assunto "Acquired Immunodeficiency Syndrome"

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    Análise da retenção à terapia antirretroviral de pessoas vivendo com HIV e fatores associados no Brasil de 2014 a 2022
    (Universidade Federal do Espírito Santo, 2025-03-26) Freitas, Marcelo Araújo de; Pascom, Ana Roberta Pati ; https://orcid.org/0000-0002-2646-3383; http://lattes.cnpq.br/1066727701162204; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/0000-0002-0763-233X; http://lattes.cnpq.br/9275784580459018; Mesquita, Fábio Caldas de; https://orcid.org/0000-0002-8297-0224; http://lattes.cnpq.br/5238492147032062; Oliveira, Maria Cristina Pimenta de ; https://orcid.org/0000-0002-4205-9786; http://lattes.cnpq.br/4908168036177095; Teixeira, Carlos Graeff ; https://orcid.org/0000-0003-2725-0061; http://lattes.cnpq.br/0464152494769261; Cerutti Junior, Crispim ; https://orcid.org/0000-0002-9485-4191; http://lattes.cnpq.br/4257067087979999
    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