Lack of effect of motivation on the adherence of HIV-positive/AIDS patients to antiretroviral treatment.

As a result of the potent drug combinations of reverse transcriptase inhibitors and protease inhibitors currently available, it is now possible to achieve extreme reductions in the numbers of viral particles in the peripheral blood of HIV-positive patients undergoing treatment, to the point that they are undetectable. Moreover, the immunological recovery resulting from continued and prolonged use of these drugs significantly reduces both mortality and the incidence of opportunistic infections. However, the strict therapeutic regimens required, the number of pills, adverse events and the stigma of a disease that requires the patient to introduce pill-taking into his/her lifestyle brings into question one aspect of mental health, which is motivation to do that which is being proposed. We investigated the influence of each of the components of the adherence trilogy: information, motivation and behavioral abilities, as risk factors in a population of HIV-positive/AIDS patients undergoing antiretroviral treatment in the city of Salvador, Bahia, Brazil.An intervention study was carried out by introducing motivational assistance into the routine recommendations for the treatment of patients who were initiating antiretroviral (ARV) therapy. Seventy-six treatment-naive patients, who had been selected to initiate ARV therapy, were included. These patients were divided into two groups. Group A, in which the regular routine of the institution was followed, received information on the disease and its treatment;patients in group B had the same routine, but they were also followed-up fortnightly and given motivational intervention. Evaluations of viral load and CD4 count before and following treatment were used to measure adherence.There was no significant difference between the two groups.As the rates of non-adhesion were at the lower limits of the ranges reported in the literature, it would appear that providing motivation and information can be of help to the patient.