Adherence to antiretroviral therapy and factors associated with non-adherence: a cohort study at two referral services in Brazil.

This cohort study evaluated non-adherence to antiretrovirals at referral services in Pernambuco, Brazil, 2016/2017, through self-report. A generalized mixed-effects model for binary outcomewas used. We assessed 542 participants with an adherence rate of 85.50%. A greater chance of non-adherence was associated with:a low/moderate level of nicotine dependence (OR = 2.79,  = 0.00, IC = 1.44-5.41); ≥7 tablets/day (OR = 6.14,  = 0.00, IC = 3.42-11.02); LPV/r (OR = 1.49,  = 0.6, IC = 0.98-2.26), ddI (OR = 3.34,  = 0.03, IC = 1.12-9.97), ABC (OR = 4.02,  = 0.05, IC = 1.01-16.03), RAL (OR = 2.49,  = 0.01, IC = 1.32-4.70) and DTG (OR = 4.65,  = 0.01, IC = 1.42-15.16); 6-10 year seropositive diagnosis (OR = 2.17,  = 0.01, IC = 1.20-3.92) and symptoms of depression (OR = 1.55,  = 0.03, IC = 1.03-2.33). Protective factors for non-adherence weres: ≥50 years (OR = 0.67,  = 0.06, IC = 0.45-1.01), secondary/higher education (OR = 0.48,  = 0.00, IC = 0.34-0.70), embarrassment at health service (OR = 0.49,  = 0.04, IC = 0.24-0.97), good understanding of antiretrovirals (OR = 0.62,  = 0.03, IC = 0.40-0.96), adverse event (OR = 0.74,  = 0,06, IC = 0.54-1.01), use of TDF (OR = 0.62,  = 0.01, IC = 0.43-0.90), NVP (OR = 0.41,  = 0.05, IC = 0.71-1.00) and EFZ (OR = 0.48,  = 0.01, IC = 0.29-0.80) and good knowledge of HIV/AIDS/ART. (OR = 0.67,  = 0.07, IC = 0.43-1.04). Variables with stronger association were those linked to ART. Systematic use of self-report adherence is recommended for priority groups.