ASSOCIATION BETWEEN SMOKING,CRACK COCAINE ABUSE AND THE DISCONTINUATION OF COMBINATION ANTIRETROVIRAL THERAPY IN RECIFE,PERNAMBUCO, BRAZIL

Despite the effectiveness of combination antiretroviral therapy in thetreatment of people living with HIV/AIDS (PLWHA), nonadherence to medication hasbecome a major threat to its effectiveness. This study aimed to estimate theprevalence of self-reported irregular use of antiretroviral therapy and the factorsassociated with such an irregularity in PLWHA. A cross-sectional study of PLWHA whoattended two referral centers in the city of Recife, in Northeastern Brazil, betweenJune 2007 and October 2009 was carried out. The study analyzed socioeconomic factors,social service support and personal habits associated with nonadherence toantiretroviral therapy, adjusted by multivariable logistic regression analysis. Theprevalence of PLWHA who reported irregular use of combination antiretroviral therapy(cART) was 25.7%. In the final multivariate model, the irregular use of cART wasassociated with the following variables: being aged less than 40 years (OR =1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) orformer smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR= 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards eachof the following groups: individuals aged less than 40 years, smokers, former smokersand crack cocaine users. Measures for giving up smoking and crack cocaine should beincorporated into HIV-control programs in order to promote greater adherence toantiretroviral drugs and thus improve the quality of life and prolong lifeexpectancy.