Profil psychosocial d'adolescents brésiliens vivant avec le VIH et adhérents au traitement : résultats de la cohorte Adoliance

Treatment adherence remains a daily challenge for people living with HIV and all the more so for HIV-infected adolescents going through multiple transitions. Numerous factors have been investigated to explain the maintenance of treatment adherence but the relationships to emerge from the research have not been consistent. The aim of this study was to describe the variables associated with treatment adherence behaviors in a cohort of adolescents living with HIV in the area of Sao Paulo (Brazil). For the purpose, a longitudinal study was conducted from May 2011 to May 2012 among 220 perinatally infected adolescents, who completed a self-administered questionnaire comprising adherence measures and covering various psychosocial variables (sense of self-efficacy, social support, perceived stress, depression, presence and intensity of antiretroviral therapy [ART]-related symptoms) at two times of measure (T0 and T1) one year apart. Results show that half of the respondents maintained optimum treatment adherence over the course of the year (adherent profile). They were characterized at the psychosocial level by lower perceived stress (P = 0.019), fewer ART side-effects (P = 0.0407) and depression-related symptoms (P = 0.0033), and a higher sense of self-efficacy (P < 0.001), compared with adolescents with a non-adherent profile. In the light of these findings, health professionals should assess certain psychosocial variables on a regular basis while proposing support interventions to maintain and strengthen treatment adherence within this vulnerable population.