Intervenções para a promoção da adesão a terapia antirretroviral de adultos com a infecção pelo HIV: revisão sistemática da literatura

Abstract

Adherence is considered one of the greatest challenges to the effectiveness of antiretroviral therapy. Thus, the objective is to identify which interventions have shown effectiveness for adherence to antiretroviral therapy for HIV infection in the adult population. This is a Systematic Review of Randomized Clinical Trials Literature, with the research question: which interventions promote the effectiveness of antiretroviral therapy adherence for HIV infection in the adult population ≥ 18 years? We searched the electronic databases: PUBMED; Excerpta Medical Database (EMBASE); Latin American Literature in Health Sciences (LILACS); Cumulative Index to Nursing and Allied Health Literature (CINAHL); Web of Science; SCOPUS. The primary studies of Randomized Clinical Trials, which evaluated the adherence to antiretroviral therapy as one of the results, were evaluated. We evaluated the studies published as of 2010. Of the 6,674 studies identified, nine studies were included in this systematic review. Among them, five were effective in improving adherence to antiretroviral therapy when compared to the control group: 1) the LifeWindons intervention presented a 12% better effectiveness rate for adhesion; 2) the intervention that used alarm and / or counseling device presented 5% more chances of presenting perfect adherence; 3) the treatment support intervention presented a 4.5% greater chance of presenting a perfect adherence; 4) the integrated behavioral risk reduction and adherence intervention presented 4% more chances of presenting perfect adherence; and 5) the problem-solving management intervention was 2.3% more likely to present perfect adherence. The thesis is defended that health interventions promote the effectiveness of adherence to antiretroviral therapy for HIV. It was necessary to carry out an evaluation in the interventions that showed effectiveness in the improvement of the adhesion, since it is not possible to define the intervention better or more complete, since the multiplicity of factors that interfere in the adhesion and, consequently, of the needs of the user.