Adherence to antiretroviral treatment and quality of life among transgender women living with HIV/AIDS in São Paulo, Brazil

• Published in: AIDS care 2021-01, Vol.33 (1), p.31-38
• Main Authors: Sabino, Thiago E., Avelino-Silva, Vivian I., Cavalcantte, Clara, Goulart, Silvia P., Luiz, Olinda C., Fonseca, Luiz A.M., Casseb, Jorge S.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adherence; Adherents; Adult; Age; Aged; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active - methods; Brazil - epidemiology; CD4 antigen; CD4 Lymphocyte Count; Cross-Sectional Studies; Diagnosis; Domains; Drug abuse; Education; Female; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - psychology; Human immunodeficiency virus; Humans; Immune response; Male; Measurement; Medical diagnosis; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Mental depression; Middle Aged; Quality assessment; Quality of life; Quality of Life - psychology; Self report; Socioeconomic Factors; Surveys and Questionnaires; Transgender persons; Transgender Persons - psychology; Transgender women; Viral Load; Women
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2019.1710449

This study focused on factors associated with antiretroviral therapy (ART) adherence and quality of life among transgenderwomen in Sao Paulo, Brazil, using univariable and adjusted analysis. Adherence was evaluated with a self-report tool and with HIV viral load (VL) measurement. PROQOL-HIV was used to assess quality of life. 106 TGW with median 41 years old were included; most were white (56%) and had >10 years of education (57%). Median time since HIV/AIDS diagnosis was 10 years. Overall, participants had high T CD4+ counts (median 659 cells/mm 3 ) and most (75%) had undetectable HIV VL. 85% were considered adherent using self-report (95%CI 77-91), whereas 72% (95%CI 62-80) were considered adherent when self-report and undetectable HIV VL were analyzed jointly. Older age was associated with higher ART adherence; each year increase in age was associated with 5% higher odds of adherence (p = 0.021). Quality of life ranged from good-excellent in 5 of 8 domains. Younger age, lower education, higher time since HIV diagnosis, comorbidities, illicit drugs use and depression were associated with lower PROQOL scores in specific domains in univariable analysis, while depression was also associated with lower total PROQOL score even after adjustment for age, comorbidities and time since HIV diagnosis (p = 0.048).