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The role of health services in patient adherence to antiretroviral treatment of HIV/AIDS: associations between adherence measures and organizational characteristics of public healthcare sites that assist people living with HIV in Brazil

Grant number: 12/20578-4
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): January 01, 2013
Effective date (End): September 30, 2015
Field of knowledge:Health Sciences - Collective Health - Public Health
Principal Investigator:Maria Ines Battistella Nemes
Grantee:Maria Altenfelder Santos
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated scholarship(s):13/06186-9 - Evaluation of performance in the Brazilian public HIV healthcare facilities: associations between patient adherence measures, size and geographic region of sites and characteristics of structure and process of care, BE.EP.DR


Background: Patient adherence to antiretroviral therapy is critical to ensure the effectiveness of treatment. Health services play an important role in patient adherence. Previous studies demonstrated associations between site characteristics and rates of adherence to antiretroviral therapy (ART). Objective: To investigate the associations between site organizational characteristics and measures of patient adherence. Methods: In a cross-sectional study conducted in 2010, fifty-five sites integrated a national sample representing different geographic regions and different performance levels (established in a previous national study). A total of 2424 patients on ART answered to a pre-validated electronic questionnaire containing three questions concerning the intake of all medications according to the number of pills and time prescribed in the last seven days. Site's manager and team responded to two instruments: a structured questionnaire about the general care organization, and a semi-structured questionnaire about activities specifically directed to adherence. Site organizational characteristics and measures of adherence to ART will be described according to the frequencies of responses. The associations between site characteristics and adherence measures will be tested in multivariate models and site will be the unit of analysis. (AU)

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